Chronic right ventricular pressure overload was associated with higher plasma BNP (5.3 vs 2.3 pmol/l, p<0.009) and ANP levels, which inversely correlated with right ventricular ejection fraction.
Cross-Sectional (n=28)
No
Do plasma BNP and ANP concentrations correlate with right ventricular dysfunction in asymptomatic or minimally symptomatic patients with chronic right ventricular pressure overload?
Plasma BNP and ANP levels inversely correlate with right ventricular ejection fraction in patients with chronic right ventricular pressure overload due to congenital heart disease, suggesting their utility in monitoring RV dysfunction.
Absolute Event Rate: 5.3% vs 2.3%
p-value: p=<0.009
OBJECTIVE: To evaluate the role of plasma neurohormones in the diagnosis of asymptomatic or minimally symptomatic right ventricular dysfunction. SETTING: Tertiary cardiovascular referral centre. METHODS: Plasma brain natriuretic peptide (BNP) and atrial natriuretic peptide (ANP) concentrations were measured in 21 asymptomatic or minimally symptomatic patients with chronic right ventricular pressure overload caused by congenital heart disease, and in seven healthy volunteers. Right ventricular ejection fraction was determined using magnetic resonance imaging. RESULTS: Right ventricular ejection fraction in the volunteers was higher than in the patients (69.0 (8.2)% v 58.0(12.0)%, respectively; p < 0.006). Left ventricular ejection fraction was 72.3(7.8)% in volunteers and 68.1(11.0)% in patients (NS). There was a significant difference between patients and volunteers in the plasma concentrations of BNP (5.3 (3.5) v 2.3 (1.7) pmol/l, respectively; p < 0.009) and ANP (7.3 (4.5) v 3.6 (1.4) pmol/l; p < 0.05). In both patients and volunteers, mean plasma ANP was higher than mean plasma BNP. Right ventricular ejection fraction was inversely correlated with BNP and ANP (respectively, r = 0.65; p < 0.0002 and r = 0.61; p < 0.002). There was no correlation between left ventricular ejection fraction and BNP (r = 0.2; NS) or ANP (r = 0.52; NS). Similarly, no correlation was shown between the level of right ventricular systolic pressure and either plasma BNP (r = 0.20) or plasma ANP (r = 0.07). CONCLUSIONS: There was a significant inverse correlation between right ventricular ejection fraction and the plasma neurohormones BNP and ANP in asymptomatic or minimally symptomatic patients with right ventricular pressure overload and congenital heart disease. Monitoring changes in BNP and ANP may provide quantitative follow up of right ventricular dysfunction in these patients.
Igor I. Tulevski (2001) conducted a cross-sectional in Chronic right ventricular pressure overload (n=28). Chronic right ventricular pressure overload vs. Healthy volunteers was evaluated on Plasma brain natriuretic peptide (BNP) concentration (pmol/l) (p=<0.009). Chronic right ventricular pressure overload was associated with higher plasma BNP (5.3 vs 2.3 pmol/l, p<0.009) and ANP levels, which inversely correlated with right ventricular ejection fraction.