Tags

Type your tag names separated by a space and hit enter

B-type natriuretic peptide levels in obese patients with advanced heart failure.
J Am Coll Cardiol. 2006 Jan 03; 47(1):85-90.JACC

Abstract

Although recent studies show that obesity, or elevated body mass index (BMI), is associated with lower levels of B-type natriuretic peptide (BNP), it is unknown whether BMI affects the prognostic value of BNP in heart failure (HF). This study confirms the relationship between high BMI and low BNP in patients with advanced systolic HF. Despite relatively lower levels of BNP in overweight and obesity, BNP predicts worse symptoms, impaired hemodynamics, and higher mortality in HF at all levels of BMI.

OBJECTIVES

This study aimed to examine the influence of obesity on the predictive value of the B-type natriuretic peptide (BNP) assay in heart failure (HF).

BACKGROUND

Recent studies show that obesity, or elevated body mass index (BMI), is associated with lower circulating levels of BNP both in the general population and in patients with HF.

METHODS

We analyzed data from 316 systolic HF (left ventricular ejection fraction [LVEF] < or =40%) patients [age, 53 +/- 13 years; mean LVEF, 24 +/- 7%; 48% ischemic] followed up at a university HF center. Patients were divided into categories of BMI: lean (BMI <25 kg/m2), overweight (BMI = 25 to 29.9 kg/m2), and obese (BMI > or =30 kg/m2).

RESULTS

The BNP levels were significantly lower in overweight and obese compared with lean patients (p = 0.0001); median BNP (interquartile range) for the lean (n = 131), overweight (n = 99), and obese (n = 86) groups was 747 (272 to 1,300), 380 (143 to 856), and 332 (118 to 617) pg/ml, respectively. In each BMI category, elevated BNP was significantly associated with worse symptoms and higher pulmonary capillary wedge pressure. Higher BNP was also a significant independent predictor of survival independent of BMI. Optimal BNP cutoff for prediction of death or urgent transplant in lean, overweight, and obese HF patients was 590, 471, and 342 pg/ml, respectively.

CONCLUSIONS

Although BNP levels are relatively lower in overweight and obese HF patients, BNP predicts worse symptoms, impaired hemodynamics, and higher mortality at all levels of BMI.

Authors+Show Affiliations

Ahmanson-UCLA Cardiomyopathy Center, UCLA Division of Cardiology, Los Angeles, California 90095-1679, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16386669

Citation

Horwich, Tamara B., et al. "B-type Natriuretic Peptide Levels in Obese Patients With Advanced Heart Failure." Journal of the American College of Cardiology, vol. 47, no. 1, 2006, pp. 85-90.
Horwich TB, Hamilton MA, Fonarow GC. B-type natriuretic peptide levels in obese patients with advanced heart failure. J Am Coll Cardiol. 2006;47(1):85-90.
Horwich, T. B., Hamilton, M. A., & Fonarow, G. C. (2006). B-type natriuretic peptide levels in obese patients with advanced heart failure. Journal of the American College of Cardiology, 47(1), 85-90.
Horwich TB, Hamilton MA, Fonarow GC. B-type Natriuretic Peptide Levels in Obese Patients With Advanced Heart Failure. J Am Coll Cardiol. 2006 Jan 3;47(1):85-90. PubMed PMID: 16386669.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - B-type natriuretic peptide levels in obese patients with advanced heart failure. AU - Horwich,Tamara B, AU - Hamilton,Michele A, AU - Fonarow,Gregg C, Y1 - 2005/12/15/ PY - 2005/05/22/received PY - 2005/07/09/revised PY - 2005/08/01/accepted PY - 2006/1/3/pubmed PY - 2006/3/28/medline PY - 2006/1/3/entrez SP - 85 EP - 90 JF - Journal of the American College of Cardiology JO - J Am Coll Cardiol VL - 47 IS - 1 N2 - UNLABELLED: Although recent studies show that obesity, or elevated body mass index (BMI), is associated with lower levels of B-type natriuretic peptide (BNP), it is unknown whether BMI affects the prognostic value of BNP in heart failure (HF). This study confirms the relationship between high BMI and low BNP in patients with advanced systolic HF. Despite relatively lower levels of BNP in overweight and obesity, BNP predicts worse symptoms, impaired hemodynamics, and higher mortality in HF at all levels of BMI. OBJECTIVES: This study aimed to examine the influence of obesity on the predictive value of the B-type natriuretic peptide (BNP) assay in heart failure (HF). BACKGROUND: Recent studies show that obesity, or elevated body mass index (BMI), is associated with lower circulating levels of BNP both in the general population and in patients with HF. METHODS: We analyzed data from 316 systolic HF (left ventricular ejection fraction [LVEF] < or =40%) patients [age, 53 +/- 13 years; mean LVEF, 24 +/- 7%; 48% ischemic] followed up at a university HF center. Patients were divided into categories of BMI: lean (BMI <25 kg/m2), overweight (BMI = 25 to 29.9 kg/m2), and obese (BMI > or =30 kg/m2). RESULTS: The BNP levels were significantly lower in overweight and obese compared with lean patients (p = 0.0001); median BNP (interquartile range) for the lean (n = 131), overweight (n = 99), and obese (n = 86) groups was 747 (272 to 1,300), 380 (143 to 856), and 332 (118 to 617) pg/ml, respectively. In each BMI category, elevated BNP was significantly associated with worse symptoms and higher pulmonary capillary wedge pressure. Higher BNP was also a significant independent predictor of survival independent of BMI. Optimal BNP cutoff for prediction of death or urgent transplant in lean, overweight, and obese HF patients was 590, 471, and 342 pg/ml, respectively. CONCLUSIONS: Although BNP levels are relatively lower in overweight and obese HF patients, BNP predicts worse symptoms, impaired hemodynamics, and higher mortality at all levels of BMI. SN - 1558-3597 UR - https://www.unboundmedicine.com/medline/citation/16386669/B_type_natriuretic_peptide_levels_in_obese_patients_with_advanced_heart_failure_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(05)02351-X DB - PRIME DP - Unbound Medicine ER -