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Clinical correlates of elevated plasma natriuretic peptides and Big endothelin-1 in a population of ambulatory patients with heart failure. A substudy of the Italian Network on Congestive Heart Failure (IN-CHF) registry. IN-CHF Investigators.
Ital Heart J. 2000 Apr; 1(4):282-8.IH

Abstract

BACKGROUND

Activation of neuroendocrine factors plays a major role in the pathophysiology and progression of heart failure. The aim of the present study was 1) to assess the clinical correlates of elevated plasma natriuretic peptides [atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP)] and Big endothelin-1 in a population of 180 ambulatory patients from the Italian registry of heart failure (Italian Network on Congestive Heart Failure, IN-CHF) in 22 clinical centers, 2) to assess the within-patient variability of plasma BNP concentration, and 3) to evaluate the analytical agreement for BNP determination between a core laboratory and local sites.

METHODS

ANP and BNP were measured with specific immunoradiometric methods, Big endothelin-1 with an enzyme immunoassay.

RESULTS

Elevated BNP was associated with severe mitral valve regurgitation (odds ratio 8.546, 95% confidence interval 1.879-38.510, p = 0.0052); high circulating concentrations of ANP and BNP were found in older patients, and in patients with higher NYHA functional class or reduced left ventricular ejection fraction. Elevated plasma concentration of Big endothelin-1 was a strong and independent predictor of atrial fibrillation (odds ratio 4.001, 95% confidence interval 1.531-10.454, p = 0.0047). Plasma concentration of BNP was reasonably stable at 3-month interval in patients with mild-to-moderate heart failure (mean between-visit difference -1.5+/-45 pg/ml, n = 96). There was a satisfactory analytical agreement between the central laboratory and sites, over a broad range of concentrations (2-1133 pg/ml, n = 283) with a slope for the best line fitted by linear regression of 1.09 (r2 = 0.96).

CONCLUSIONS

BNP assay may become an appropriate tool for routine clinical practice in patients with congestive heart failure.

Authors+Show Affiliations

Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10824729

Citation

Masson, S, et al. "Clinical Correlates of Elevated Plasma Natriuretic Peptides and Big Endothelin-1 in a Population of Ambulatory Patients With Heart Failure. a Substudy of the Italian Network On Congestive Heart Failure (IN-CHF) Registry. IN-CHF Investigators." Italian Heart Journal : Official Journal of the Italian Federation of Cardiology, vol. 1, no. 4, 2000, pp. 282-8.
Masson S, Gorini M, Salio M, et al. Clinical correlates of elevated plasma natriuretic peptides and Big endothelin-1 in a population of ambulatory patients with heart failure. A substudy of the Italian Network on Congestive Heart Failure (IN-CHF) registry. IN-CHF Investigators. Ital Heart J. 2000;1(4):282-8.
Masson, S., Gorini, M., Salio, M., Lucci, D., Latini, R., & Maggioni, A. P. (2000). Clinical correlates of elevated plasma natriuretic peptides and Big endothelin-1 in a population of ambulatory patients with heart failure. A substudy of the Italian Network on Congestive Heart Failure (IN-CHF) registry. IN-CHF Investigators. Italian Heart Journal : Official Journal of the Italian Federation of Cardiology, 1(4), 282-8.
Masson S, et al. Clinical Correlates of Elevated Plasma Natriuretic Peptides and Big Endothelin-1 in a Population of Ambulatory Patients With Heart Failure. a Substudy of the Italian Network On Congestive Heart Failure (IN-CHF) Registry. IN-CHF Investigators. Ital Heart J. 2000;1(4):282-8. PubMed PMID: 10824729.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical correlates of elevated plasma natriuretic peptides and Big endothelin-1 in a population of ambulatory patients with heart failure. A substudy of the Italian Network on Congestive Heart Failure (IN-CHF) registry. IN-CHF Investigators. AU - Masson,S, AU - Gorini,M, AU - Salio,M, AU - Lucci,D, AU - Latini,R, AU - Maggioni,A P, PY - 2000/5/29/pubmed PY - 2000/7/25/medline PY - 2000/5/29/entrez SP - 282 EP - 8 JF - Italian heart journal : official journal of the Italian Federation of Cardiology JO - Ital Heart J VL - 1 IS - 4 N2 - BACKGROUND: Activation of neuroendocrine factors plays a major role in the pathophysiology and progression of heart failure. The aim of the present study was 1) to assess the clinical correlates of elevated plasma natriuretic peptides [atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP)] and Big endothelin-1 in a population of 180 ambulatory patients from the Italian registry of heart failure (Italian Network on Congestive Heart Failure, IN-CHF) in 22 clinical centers, 2) to assess the within-patient variability of plasma BNP concentration, and 3) to evaluate the analytical agreement for BNP determination between a core laboratory and local sites. METHODS: ANP and BNP were measured with specific immunoradiometric methods, Big endothelin-1 with an enzyme immunoassay. RESULTS: Elevated BNP was associated with severe mitral valve regurgitation (odds ratio 8.546, 95% confidence interval 1.879-38.510, p = 0.0052); high circulating concentrations of ANP and BNP were found in older patients, and in patients with higher NYHA functional class or reduced left ventricular ejection fraction. Elevated plasma concentration of Big endothelin-1 was a strong and independent predictor of atrial fibrillation (odds ratio 4.001, 95% confidence interval 1.531-10.454, p = 0.0047). Plasma concentration of BNP was reasonably stable at 3-month interval in patients with mild-to-moderate heart failure (mean between-visit difference -1.5+/-45 pg/ml, n = 96). There was a satisfactory analytical agreement between the central laboratory and sites, over a broad range of concentrations (2-1133 pg/ml, n = 283) with a slope for the best line fitted by linear regression of 1.09 (r2 = 0.96). CONCLUSIONS: BNP assay may become an appropriate tool for routine clinical practice in patients with congestive heart failure. SN - 1129-471X UR - https://www.unboundmedicine.com/medline/citation/10824729/Clinical_correlates_of_elevated_plasma_natriuretic_peptides_and_Big_endothelin_1_in_a_population_of_ambulatory_patients_with_heart_failure__A_substudy_of_the_Italian_Network_on_Congestive_Heart_Failure__IN_CHF__registry__IN_CHF_Investigators_ L2 - https://medlineplus.gov/heartfailure.html DB - PRIME DP - Unbound Medicine ER -