RELATIONSHIP BETWEEN PLASMA-LEVEL OF BRAIN NATRIURETIC PEPTIDE AND MYOCARDIAL INFARCT SIZE

To investigate the clinical significance of plasma brain natriuretic p eptide (BNP) measurement in patients with acute myocardial infarction (MI), circulating levels of BNP, atrial natriuretic peptide, creatine kinase (CK), and hemodynamic parameters were serially determined in 24 patients with a first episode of acute MI. Plasma BNP (mean +/- SEM) gradually increased and peaked 21 h after the onset (from 13.7 +/- 2.2 to 23.0 +/- 3.3 fmol/ml; p < 0.001). A significant correlation was fo und between the increase in plasma BNP level and both the peak CK leve l (r = 0.83; p < 0.05) and the MI size (r = 0.74; p < 0.05). The incre ase in plasma BNP in the acute phase was found to be a significant pre dictor of left ventricular (LV) function evaluated in the convalescent phase (LV ejection fraction, r = -0.63; p < 0.05, LV end-diastolic pr essure, r 0.56; p < 0.05). In conclusion, in patients with acute MI, i ncreases in plasma BNP concentration during the early phase reflect MI size, and thereby may predict later LV function.