Measurement of plasma brain natriuretic peptide level as a guide for cardiac overload

Objectives: We examined whether measurement of the plasma BNP concentration s might be useful for the early diagnosis of the existence and severity of disease in patients with heart disease in daily clinical practice. Methods and Results: The plasma BNP and ANP concentrations in 415 patients with hea rt disease and hypertension and 65 control subjects were measured. Patients with heart disease had higher plasma BNP and ANP concentrations than did t hose with hypertension or control subjects. Among the etiology of cardiac d iseases, specifically dilated cardiomyopathy and hypertrophic cardiomyopath y, was associated with the highest plasma BNP concentrations, whereas dilat ed cardiomyopathy was associated with the highest plasma ANP concentrations . Plasma BNP concentrations showed an increase as the severity of the heart disease, as graded according to the NYHA classification of cardiac functio n, increased. In both patients with heart disease and hypertension, the pla sma BNP values were higher in those who had abnormalities in their echocard iogram and electrocardiogram as compared to those without any abnormalities . The plasma BNP levels also showed a significant correlation with left ven tricular wall thickness and left ventricular mass. On the other hand, the p lasma ANP levels showed significant correlations with left ventricular dime nsion. Receiver operative characteristic analysis revealed that plasma BNP levels showed substantially high sensitivity and specificity to detect the existence of heart diseases. Conclusion: Measurements of the plasma BNP con centrations is useful to detect the existence of the diseases, and abnormal ities of left ventricular function and hypertrophy in patients with heart d isease in daily clinical practice. (C) 2001 Elsevier Science BY All rights reserved.