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Determinants and clinical significance of natriuretic peptides and hypertrophic cardiomyopathy.
- Source :
-
European heart journal [Eur Heart J] 2001 Aug; Vol. 22 (15), pp. 1328-36. - Publication Year :
- 2001
-
Abstract
- Aims: Atrial and brain natriuretic peptide levels closely reflect impaired left ventricular function in patients with heart failure. In the present study we assessed the determinants and the clinical significance of atrial and brain natriuretic peptide plasma levels in hypertrophic cardiomyopathy.<br />Methods and Results: In 44 patients with hypertrophic cardiomyopathy (40+/-15 years) we evaluated: (a) atrial and brain natriuretic peptide plasma levels; (b) left ventricular hypertrophy; (c) left ventricular ejection fraction; (d) transmitral and pulmonary venous flow velocity patterns, and left atrial fractional shortening; (e) left ventricular outflow tract gradient; (f) maximal oxygen consumption. Left ventricular hypertrophy influenced only brain natriuretic peptide levels (r=0.32;P<0.05). Atrial and brain natriuretic peptide plasma levels did not correlate with left ventricular ejection fraction, but correlated with left ventricular outflow tract gradient (r=0.35;P<0.05; and r=0.40, P=0.022, respectively) and left atrial fractional shortening (r=-0.57;P<0.001, and r=-0.35;P<0.05, respectively). Atrial but not brain natriuretic peptide plasma levels were inversely related to maximal oxygen consumption (r=-0.35;P<0.05). By stepwise multiple regression analysis, left atrial fractional shortening and left ventricular outflow tract gradient were the only predictors of atrial and brain natriuretic peptide plasma levels, respectively.<br />Conclusions: In hypertrophic cardiomyopathy, atrial natriuretic peptide plasma levels are mainly determined by diastolic function: this explains the relationship with exercise tolerance. In contrast, brain natriuretic peptide plasma levels are mainly determined by left ventricular outflow tract gradient.<br /> (Copyright 2001 The European Society of Cardiology.)
- Subjects :
- Adolescent
Adult
Aged
Cardiomyopathy, Hypertrophic diagnostic imaging
Cardiomyopathy, Hypertrophic physiopathology
Echocardiography, Doppler
Exercise Test
Female
Humans
Male
Middle Aged
Myocardial Contraction
Regression Analysis
Stroke Volume
Ventricular Function, Left
Atrial Natriuretic Factor blood
Cardiomyopathy, Hypertrophic blood
Natriuretic Peptide, Brain blood
Subjects
Details
- Language :
- English
- ISSN :
- 0195-668X
- Volume :
- 22
- Issue :
- 15
- Database :
- MEDLINE
- Journal :
- European heart journal
- Publication Type :
- Academic Journal
- Accession number :
- 11465965
- Full Text :
- https://doi.org/10.1053/euhj.2000.2535