Plasma brain natriuretic peptide is a biochemical marker for the prediction of progressive ventricular remodeling after acute myocardial infarction

• Published in: The American heart journal 1998, Vol.135 (1), p.21-28
• Main Authors: Nagaya, Noritoshi, Nishikimi, Toshio, Goto, Yoichi, Miyao, Yuji, Kobayashi, Yoshio, Morii, Isao, Daikoku, Satoshi, Matsumoto, Takahiro, Miyazaki, Shunichi, Matsuoka, Hiroaki, Takishita, Shuichi, Kangawa, Kenji, Matsuo, Hisayuki, Nonogi, Hiroshi
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Atrial Natriuretic Factor - blood; Biological and medical sciences; Biomarkers - blood; Cardiology. Vascular system; Coronary heart disease; Female; Heart; Hemodynamics; Humans; Hypertrophy, Left Ventricular - blood; Hypertrophy, Left Ventricular - etiology; Male; Medical sciences; Middle Aged; Myocardial Infarction - blood; Myocardial Infarction - complications; Myocardial Infarction - physiopathology; Natriuretic Peptide, Brain; Nerve Tissue Proteins - blood; Predictive Value of Tests; Ventricular Function, Left
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/S0002-8703(98)70338-2

To investigate the relation between plasma brain natriuretic peptide (BNP) and progressive ventricular remodeling, we measured plasma BNP and atrial natriuretic peptide (ANP) in 30 patients with acute myocardial infarction on days 2, 7, 14, and 30 after the onset. Left ventricular end-diastolic volume index (EDVI), end-systolic volume index (ESVI), and ejection fraction (EF) on admission and 1 month after the onset were assessed by left ventriculography. Changes in EDVI (ΔEDVI), ESVI (ΔESVI), and EF (ΔEF) were obtained by subtracting respective acute-phase values from corresponding chronic-phase values. Plasma ANP on days 2 and 7 showed only weak correlations with ΔEDVI ( r = 0.48 and 0.54; both p < 0.01), whereas plasma BNP on day 7 more closely correlated with ΔEDVI ( r = 0.77; p < 0.001). When study patients were divided into two groups according to plasma BNP on day 7, the group with BNP higher than 100 pg/ml showed greater increases in left ventricular volume and less improvement in EF compared with the other group with BNP lower than 100 pg/ml (ΔEDVI = 10.4 ± 8 vs –3.4 ± 9 ml/m 2, DESVI = 6.2 ± 7 vs –4.9 ± 5 ml/m 2, and DEF = 1.0% ± 4% vs 4.9% ± 5%; p < 0.05, respectively). Multiple regression analysis revealed that only plasma BNP on day 7, but not ANP, peak creatine phosphokinase level, left ventricular end-diastolic pressure, or acute-phase EF, correlated independently with ΔEDVI ( p < 0.01). These results suggest that plasma BNP may be a simple and useful biochemical marker for the prediction of progressive ventricular remodeling within the first 30 days of acute myocardial infarction. (Am Heart J 1998;135:21-8.)