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Plasma brain natriuretic peptide level as a biochemical marker of morbidity and mortality in patients with asymptomatic or minimally symptomatic left ventricular dysfunction. Comparison with plasma angiotensin II and endothelin-1.
Eur Heart J. 1999 Dec; 20(24):1799-807.EH

Abstract

AIMS

To evaluate the level of plasma brain natriuretic peptide as a predictor of morbidity and mortality in patients with asymptomatic or minimally symptomatic left ventricular dysfunction.

METHODS

We measured plasma levels of atrial natriuretic peptide, brain natriuretic peptide, norepinephrine, angiotensin II, and endothelin-1 and monitored haemodynamic parameters in 290 consecutive patients with asymptomatic or minimally and newly symptomatic left ventricular dysfunction (functional classes I-II, mean left ventricular ejection fraction=37%). All patients were followed up for a median period of 812 days. The Cox proportional hazards model was used to assess the association of variables with mortality and morbidity.

RESULTS

At the end of the follow-up, 24 patients had suffered cardiac death and 25 had been hospitalized for worsening heart failure during the follow-up period. Among 21 variables such as clinical characteristics, treatment, haemodynamics, and neurohumoral factors, high levels of plasma brain natriuretic peptide (P<0.0001), norepinephrine (P=0.042), left ventricular end-diastolic volume index (P=0.0035), and left ventricular end-diastolic pressure (P=0.033) were shown to be independent predictors of mortality and morbidity by stepwise multivariate analysis. Moreover, only a high level of plasma brain natriuretic peptide (P<0.0001) was shown to be an independent predictor of mortality in these patients.

CONCLUSIONS

These results indicate that a high plasma brain natriuretic peptide level provides information about mortality and morbidity in patients with asymptomatic or minimally symptomatic left ventricular dysfunction.

Authors+Show Affiliations

First Department of Internal Medicine, Shiga University of Medical Science, Tsukinowa, Seta, Otsu, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

10581138

Citation

Tsutamoto, T, et al. "Plasma Brain Natriuretic Peptide Level as a Biochemical Marker of Morbidity and Mortality in Patients With Asymptomatic or Minimally Symptomatic Left Ventricular Dysfunction. Comparison With Plasma Angiotensin II and Endothelin-1." European Heart Journal, vol. 20, no. 24, 1999, pp. 1799-807.
Tsutamoto T, Wada A, Maeda K, et al. Plasma brain natriuretic peptide level as a biochemical marker of morbidity and mortality in patients with asymptomatic or minimally symptomatic left ventricular dysfunction. Comparison with plasma angiotensin II and endothelin-1. Eur Heart J. 1999;20(24):1799-807.
Tsutamoto, T., Wada, A., Maeda, K., Hisanaga, T., Mabuchi, N., Hayashi, M., Ohnishi, M., Sawaki, M., Fujii, M., Horie, H., Sugimoto, Y., & Kinoshita, M. (1999). Plasma brain natriuretic peptide level as a biochemical marker of morbidity and mortality in patients with asymptomatic or minimally symptomatic left ventricular dysfunction. Comparison with plasma angiotensin II and endothelin-1. European Heart Journal, 20(24), 1799-807.
Tsutamoto T, et al. Plasma Brain Natriuretic Peptide Level as a Biochemical Marker of Morbidity and Mortality in Patients With Asymptomatic or Minimally Symptomatic Left Ventricular Dysfunction. Comparison With Plasma Angiotensin II and Endothelin-1. Eur Heart J. 1999;20(24):1799-807. PubMed PMID: 10581138.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Plasma brain natriuretic peptide level as a biochemical marker of morbidity and mortality in patients with asymptomatic or minimally symptomatic left ventricular dysfunction. Comparison with plasma angiotensin II and endothelin-1. AU - Tsutamoto,T, AU - Wada,A, AU - Maeda,K, AU - Hisanaga,T, AU - Mabuchi,N, AU - Hayashi,M, AU - Ohnishi,M, AU - Sawaki,M, AU - Fujii,M, AU - Horie,H, AU - Sugimoto,Y, AU - Kinoshita,M, PY - 1999/12/3/pubmed PY - 2000/2/19/medline PY - 1999/12/3/entrez SP - 1799 EP - 807 JF - European heart journal JO - Eur. Heart J. VL - 20 IS - 24 N2 - AIMS: To evaluate the level of plasma brain natriuretic peptide as a predictor of morbidity and mortality in patients with asymptomatic or minimally symptomatic left ventricular dysfunction. METHODS: We measured plasma levels of atrial natriuretic peptide, brain natriuretic peptide, norepinephrine, angiotensin II, and endothelin-1 and monitored haemodynamic parameters in 290 consecutive patients with asymptomatic or minimally and newly symptomatic left ventricular dysfunction (functional classes I-II, mean left ventricular ejection fraction=37%). All patients were followed up for a median period of 812 days. The Cox proportional hazards model was used to assess the association of variables with mortality and morbidity. RESULTS: At the end of the follow-up, 24 patients had suffered cardiac death and 25 had been hospitalized for worsening heart failure during the follow-up period. Among 21 variables such as clinical characteristics, treatment, haemodynamics, and neurohumoral factors, high levels of plasma brain natriuretic peptide (P<0.0001), norepinephrine (P=0.042), left ventricular end-diastolic volume index (P=0.0035), and left ventricular end-diastolic pressure (P=0.033) were shown to be independent predictors of mortality and morbidity by stepwise multivariate analysis. Moreover, only a high level of plasma brain natriuretic peptide (P<0.0001) was shown to be an independent predictor of mortality in these patients. CONCLUSIONS: These results indicate that a high plasma brain natriuretic peptide level provides information about mortality and morbidity in patients with asymptomatic or minimally symptomatic left ventricular dysfunction. SN - 0195-668X UR - https://www.unboundmedicine.com/medline/citation/10581138/Plasma_brain_natriuretic_peptide_level_as_a_biochemical_marker_of_morbidity_and_mortality_in_patients_with_asymptomatic_or_minimally_symptomatic_left_ventricular_dysfunction__Comparison_with_plasma_angiotensin_II_and_endothelin_1_ L2 - https://academic.oup.com/eurheartj/article-lookup/doi/10.1053/euhj.1999.1746 DB - PRIME DP - Unbound Medicine ER -