N. Nagaya et al., PLASMA BRAIN NATRIURETIC PEPTIDE IS A BIOCHEMICAL MARKER FOR THE PREDICTION OF PROGRESSIVE VENTRICULAR REMODELING AFTER ACUTE MYOCARDIAL-INFARCTION, The American heart journal, 135(1), 1998, pp. 21-28
To investigate the relation between plasma brain natriuretic peptide (
BNP) and progressive ventricular remodeling, we measured plasma BNP an
d atrial natriuretic peptide (ANP) in 30 patients with acute myocardia
l infarction on days 2, 7, 14, and 30 after the onset. left ventricula
r end-diastolic volume index (EDVI), end-systolic volume index (ESVI),
and election Fraction (EF) on admission and 1 month after the onset w
ere assessed by left ventriculography. Changes in EDVI (Delta EDVI), E
SVI (Delta ESVI), and EF (Delta EF) were obtained by subtracting respe
ctive acute-phase values from corresponding chronic-phase values. Plas
ma ANP on days 2 and 7 showed only weak correlations with Delta EDVI (
r = 0.48 and 0.54; both p < 0.01), whereas plasma BNP on day 7 more cl
osely correlated with Delta EDVI (r = 0.77; p < 0.001). When study pat
ients were divided into two groups according to plasma BNP on day 7, t
he group with BNP higher than 100 pg/ml showed greater increases in le
ft ventricular volume and less improvement in EF compared with the oth
er group with BNP lower than 100 pg/ml (Delta EDVI = 10.4 +/- 8 vs -3.
4 +/- 9 ml/m(2), Delta ESVI = 6.2 +/- 7 vs -4.9 +/- 5 ml/m(2), and Del
ta EF = 1.0% +/- 4% vs 4.9% +/- 5%; p < 0.05, respectively). Multiple
regression analysis revealed that only plasma BNP on day 7, but not AN
P, peak creatine phosphokinase level, left ventricular end-diastolic p
ressure, or acute-phase EF, correlated independently with Delta EDVI (
p < 0.01). These results suggest that plasma BNP may be a simple and u
seful biochemical marker For the prediction of progressive ventricular
remodeling within the first 30 days of acute myocardial infarction.