Direct Comparison of Brain Natriuretic Peptide (BNP) and N-Terminal Pro-BNP Secretion and Extent of Coronary Artery Stenosis in Patients With Stable Coronary Artery Disease

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概要

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• Background It is unclear whether coronary artery stenosis affects the secretion of N-terminal pro-brain natriuretic peptide (NT-proBNP) and brain natriuretic peptide (BNP) from the heart independent of ventricular dysfunction. Therefore, this study evaluated the relationship between BNP and NT-proBNP secretion, plasma levels and the severity of coronary artery stenosis in patients with stable coronary artery disease (CAD). Methods and Results Plasma levels of BNP and NT-proBNP in the aortic root (AO) and coronary sinus (CS) in 251 consecutive patients with stable CAD were measured. The transcardiac increase of NT-proBNP was significantly increased with the severity of coronary artery stenosis (p=0.012), but that of BNP was not (p=0.116). The molar ratio of the (CS-AO) NT-pro-BNP/(CS-AO) BNP increased with the severity of coronary artery stenosis (p=0.019) and decreased after coronary revascularization (p=0.018, n=36). Step-wise multivariate linear regression analyses were used to detect independent predictors of the (CS-AO) NT-proBNP among 10 variables including hemodynamic parameters and the Gensini score, which is a measure of the extent and sever- ity of CAD. Among these variables, left ventricular ejection fraction (p<0.0001), left ventricular end-diastolic pressure (p=0.003) and log Gensini score (p=0.008) were significant independent predictors. Conclusion These findings suggest that the transcardiac increase of NT-proBNP from the heart increases with the severity of coronary artery stenosis independent of hemodynamic overload, and plasma NT-proBNP may be superior to BNP to assess disease severity in CAD patients.

• 社団法人日本循環器学会の論文
• 2007-03-20

著者

• TSUTAMOTO Takayoshi

  Cardiovascular and Respiratory Medicine, Shiga University of Medical Science

• TANAKA Toshinari

  Cardiovascular and Respiratory Medicine, Shiga University of Medical Science

• YAMAMOTO Takashi

  Cardiovascular and Respiratory Medicine, Shiga University of Medical Science

• FUJII Masanori

  Cardiovascular and Respiratory Medicine, Shiga University of Medical Science

• HORIE Minoru

  Cardiovascular and Respiratory Medicine, Shiga University of Medical Science

• Sakai Hiroshi

  Cardiovascular And Respiratory Medicine Shiga University Of Medical Science

• Fujii Masanori

  Department Of Cardiovascular And Respiratory Medicine Shiga University Of Medical Science

• Yamamoto Takashi

  Department Of Cardiovascular And Respiratory Medicine Shiga University Of Medical Science

• Tsutamoto Takayoshi

  Department Of Cardiovascular And Respiratory Medicine Shiga University Of Medical Science

• Tanaka Toshinari

  Department Of Cardiovascular And Respiratory Medicine Shiga University Of Medical Science

• Horie Minoru

  Cardiovascular And Respiratory Medicine Shiga University Of Medical Science

• Takashima Hiroyuki

  Department Of Cardiovascular And Respiratory Medicine Shiga University Of Medical Science

• Tsutamoto Takayoshi

  Cardiovascular And Respiratory Medicine Shiga University Of Medical Science

• Takashima Hiroyuki

  Cardiovascular And Respiratory Medicine Shiga University Of Medical Science

• Hone Minoru

  Department Of Cardiovascular And Respiratory Medicine Siga University Of Medical Science

• Tsutamoto Takayoshi

  Department Of Internal Medicine Shiga University Of Medical Science

• Yabe Takahiro

  Department Of Cardiology Shiga University Of Medical Science

• Yamamoto Takashi

  Cardiovascular And Respiratory Medicine Shiga University Of Medical Science

• Fujii Masanori

  Cardiovascular And Respiratory Medicine Shiga University Of Medical Science

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