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J Am Coll Cardiol. 2006 Feb 7;47(3):582-6. Epub 2006 Jan 18.

Relationship between renal function and plasma brain natriuretic peptide in patients with heart failure.

Author information

1
Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan. tutamoto@belle.shiga-med.ac.jp

Abstract

OBJECTIVES:

This study sought to evaluate the relationship between brain natriuretic peptide (BNP), renal function, and the severity of congestive heart failure (CHF).

BACKGROUND:

Both BNP and renal function are prognostic predictors in CHF patients.

METHODS:

We measured the plasma BNP level in the aortic root and coronary sinus in 366 consecutive patients with CHF. Estimated glomerular filtration rate (eGFR) by the Cockcroft-Gault equation was used as an indicator of renal function.

RESULTS:

By stepwise multivariate analyses, hemodynamic parameters such as left ventricular ejection fraction (LVEF) and left ventricular end-diastolic pressure (LVEDP) but not eGFR were independent predictors of a transcardiac increase (coronary sinus-aortic root) in BNP. Regarding the plasma level of BNP in the aortic root, not only LVEF (p < 0.0001) and LVEDP (p < 0.0001) but also eGFR (p < 0.0001) were independent predictors. Patients were divided into two groups, patients with an eGFR > or =60 ml/min (group 1, n = 229) and patients with an eGFR <60 ml/min (group 2, n = 137). There was no difference in LVEF, LVEDP, or the transcardiac gradient of BNP between the two groups, but the plasma level of BNP in the aortic root was approximately two-fold greater in group 2 than in the group 1.

CONCLUSIONS:

These findings suggest that decreased clearance from the kidney contributes to the elevated BNP in CHF patients with renal dysfunction, especially in patients with an eGFR <60 ml/min.

PMID:
16458140
DOI:
10.1016/j.jacc.2005.10.038
[Indexed for MEDLINE]
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