Correlation of Plasma Concentrations of B-Type Natriuretic Peptide With Infarct Size Quantified by Tomographic Thallium-201 Myocardial Scintigraphy in Asymptomatic Patients With Previous Myocardial lnfarction

BACKGROUND: Secretion of A-type (atrial) and B-type (brain) natriuretic peptides (ANP and BNP) increases in relation to left ventricular (LV) dysfunction in patients with myocardial infarction (MI). However, it is unknown what determines the concentrations of ANP and BNP in asymptomatic MI patients with preserved LV function, so the aim of the present study was to examine if they are associated with MI size. METHODS AND RESULTS: Plasma concentrations of ANP and BNP in the peripheral blood were measured in 88 asymptomatic (New York Heart Association class I) patients with previous MI. The infarct size was quantitatively calculated from rest thallium-201 myocardial single photon emission computed tomography. In multivariate linear regression analysis that included MI size, hemodynamic parameters, and age as covariables, only BNP concentrations had a significant association with MI size (p=0.0001). In contrast, ANP concentrations were not significantly correlated with MI size in either the univariate or multivariate analysis. CONCLUSIONS: BNP but not ANP concentrations increased in proportion to the scintigraphic MI size despite the lack of heart failure in asymptomatic patients with previous MI. Thus, the increase in plasma BNP concentrations reflects the MI size, an important determinant of prognosis, in asymptomatic patients with MI.