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Relationship between renal function and plasma brain natriuretic peptide in patients with heart failure.

Abstract：

OBJECTIVES:This study sought to evaluate the relationship between brain natriuretic peptide (BNP), renal function, and the severity of congestive heart failure (CHF). BACKGROUND:Both BNP and renal function are prognostic predictors in CHF patients. METHODS:We measured the plasma BNP level in the aortic root and coronary sinus in 366 consecutive patients with CHF. Estimated glomerular filtration rate (eGFR) by the Cockcroft-Gault equation was used as an indicator of renal function. RESULTS:By stepwise multivariate analyses, hemodynamic parameters such as left ventricular ejection fraction (LVEF) and left ventricular end-diastolic pressure (LVEDP) but not eGFR were independent predictors of a transcardiac increase (coronary sinus-aortic root) in BNP. Regarding the plasma level of BNP in the aortic root, not only LVEF (p < 0.0001) and LVEDP (p < 0.0001) but also eGFR (p < 0.0001) were independent predictors. Patients were divided into two groups, patients with an eGFR > or =60 ml/min (group 1, n = 229) and patients with an eGFR <60 ml/min (group 2, n = 137). There was no difference in LVEF, LVEDP, or the transcardiac gradient of BNP between the two groups, but the plasma level of BNP in the aortic root was approximately two-fold greater in group 2 than in the group 1. CONCLUSIONS:These findings suggest that decreased clearance from the kidney contributes to the elevated BNP in CHF patients with renal dysfunction, especially in patients with an eGFR <60 ml/min.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Tsutamoto T,Wada A,Sakai H,Ishikawa C,Tanaka T,Hayashi M,Fujii M,Yamamoto T,Dohke T,Ohnishi M,Takashima H,Kinoshita M,Horie M

doi

10.1016/j.jacc.2005.10.038

subject

Has Abstract

pub_date

2006-02-07 00:00:00

pages

582-6

issue

3

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(05)02645-8

journal_volume

47

pub_type

杂志文章

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