N-Terminal Pro-B-Type Natriuretic Peptide in Patients with Hypertensive Heart Disease

• Published in: Journal of medical biochemistry 2011-07, Vol.30 (3), p.244-249
• Main Authors: Pejović, Janko, Ignjatović, Svetlana, Dajak, Marijana, Majkić-Singh, Nada, Vučinić, Žarko
• Format: Article
• Language: English
• Subjects: hipertenzivna kardiomiopatija; hipertenzivna srčana oboljenja; hyper tensive heart disease; hypertensive cardiomyopathy; hypertensive heart disease; N-terminal pro-B-type natriuretic peptide; N-terminalni pro-B-tip natriuretskog peptida
• ISSN: 1452-8258; 1452-8266
• DOI: 10.2478/v10011-011-0016-4

Patients with hypertensive heart disease have elevated concentrations of N-terminal pro-B-type natriuretic peptide (NT-proBNP). The aim of our study was to evaluate NT-proBNP in patients with long-standing hypertension and in patients with signs of hypertensive cardiomyopathy. The study included three groups of 50 subjects: healthy persons (Control Group), patients with hypertension and normal left ventricular systolic function (Group 1) and patients with longstanding hypertension and signs of hyper tensive cardiomyopathy with impaired left ventricular systolic function (Group 2). Our results show a very good correlation (Pearson's test) between NT-proBNP in Group 1 and Group 2 and C-reactive protein (Group 1: r = 0.8424; Group 2: r = 0.6650), systolic blood pressure (Group 1: r = 0.7213; Group 2: r = 0.4856), diastolic blood pressure (Group 1: r = 0.4282; Group 2: r = 0.3989) and ejection fraction (Group 1: r = -0.7390; Group 2: r = 0.9111). ROC analysis revealed that the AUC between the Control Group and Group 1 for NT-proBNP (0.912) was not significantly different (p>0.05) from the AUC for systolic (0.924) and diastolic pressure (0.937). A cut-off value for NT-proBNP of 5.89 pmol/L can be used to reliably distinguish patients of Group 1 from the Control Group, and a cut-off value of 21.67 pmol/L reliably separates patients from Group 1 and Group 2 (in both cases, the AUC is 1.000). Patients in Group 2 who belonged to the II and III New York Heart Association (NYHA) class had significantly higher levels of NT-proBNP than those in NYHA class I (ANOVA test, p=0.001). These data suggest that NT-proBNP is a useful biomarker for distin guishing patients with long-standing hypertension who are at risk of heart failure, allowing optimization and proper treatment of these patients. Pacijenti sa hipertenzivnim srčanim oboljenjima imaju povišene koncentracije N-terminalnog pro-B-tipa natriuretskog peptida (NT-proBNP). Cilj rada bio je da se izvrši evaluacija razlika u NT-proBNP kod pacijenata sa dugogodišnjom arterijskom hipertenzijom i znacima hipertenzivne kardiomiopatije. Ispitivanje je obuhvatilo tri grupe sa po 50 ispitanika: zdrave osobe (kontrolna grupa), pacijente sa arterijskom hipertenzijom i normalnom sistolnom funkcijom leve komore (grupa 1) i pacijente sa dugogodišnjom arterijskom hipertenzijom i znacima hipertenzivne kardiomiopatije sa oslabljenom sistolnom funkcijom leve komore (grupa 2). Dobijeni podaci pokazali su da NT-proBNP u grupi 1 kao i u gr