Indian Journal of Medical Biochemistry

Register      Login

VOLUME 23 , ISSUE 1 ( January-April, 2019 ) > List of Articles

Original Article

Plasma B-type Natriuretic Peptide Levels in Stable Heart Failure Patients

A Khadeja Bi, R Chitraa

Keywords : B-type natriuretic peptide, Biomarker, Case-control study, Heart failure

Citation Information : Bi AK, Chitraa R. Plasma B-type Natriuretic Peptide Levels in Stable Heart Failure Patients. Indian J Med Biochem 2019; 23 (1):189-192.

DOI: 10.5005/jp-journals-10054-0083

License: CC BY-NC 4.0

Published Online: 01-04-2019

Copyright Statement:  Copyright © 2019; The Author(s).


Abstract

Introduction: Heart failure (HF) is a major and growing public health problem among the global population. Cardiac biomarkers are a promising tool for the early and specific detection of heart failure. B-type natriuretic peptide (BNP) is one such cardiac biomarker released in response to ventricular myocyte stretch. Aim: The aim of the present study was to estimate the levels of plasma BNP in patients with stable chronic heart failure (CHF) and to compare them with controls. Further to correlate the relationship between plasma BNP levels and factors like age, gender and left ventricular ejection fraction (LVEF), in the two groups. Materials and methods: A case-control study conducted in Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India consisting of 55 stable CHF patients on treatment and 35 controls. Serum creatinine was estimated adopting modified Jaffe's method. eGFR was calculated using the modification of diet in renal disease (MDRD) formula. Plasma BNP levels were measured by ELISA. Results: The mean BNP concentration in patients with stable CHF was 60.46 ± 16.13 pg/mL, while in controls it was 20.94 ± 5.81pg/mL and the difference was highly significant (p= 0.001). As the age increases an increasing trend in the values of plasma BNP was observed in both groups. There was a strong negative linear relationship (r = -0.798) observed between LVEF and BNP levels in the study population. A cut-off level of 30.2pg/mL for plasma BNP had a 100% sensitivity and specificity to predict CHF. Conclusion: Our study concludes that plasma BNP was significantly higher in patients with stable chronic heart failure than in the controls. Plasma BNP as a biomarker will help in identifying stable CHF patients who are asymptomatic, on their adequacy of treatment.


PDF Share
  1. Dickstein K, Cohen-Solal A, Filippatos G, et al. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the diagnosis and treatment of acute and chronic heart failure 2008 of the European Society of Cardiology. Eur J Heart Fail 2008;10: 933-989.
  2. Ambrosy AP, Fonarow GC, Butler J, et al. The Global Health and Economic Burden of Hospitalizations for Heart Failure. Lessons Learned From Hospitalized Heart Failure Registries. J Am Coll Cardiol 2014; 63:1123-1133.
  3. Braunwald E. Heart failure. JACC Heart Fail 2013;1:1-20.
  4. Schellenberger U, O'Rear J, Guzzetta A, et al. The precursor to B-type natriuretic peptide is an O-linked glycoprotein. Arch. Biochem. Biophys. 2006;451(2):160-166.
  5. Battaglia M, Pewsner D, Juni P, et al. Accuracy of B-type natriuretic peptide tests to exclude congestive heart failure: systematic review of test accuracy studies. Arch Intern Med. 2006 May 22;166(10): 1073-1080.
  6. Austin WJ, Bhalla V, Hernandez-Arce I, et al. Correlation and prognostic utility of B-type natriuretic peptide and its amino-terminal fragment in patients with chronic kidney disease. 2006, Am. J. Clin. Pathol. 126(4):506-512.
  7. Kim HN, Januzzi Jr JL. Natriuretic peptide testing in Heart failure, Circulation, 2011;123:2015-2019.
  8. Leto L, Testa M, Feola M. Correlation between B-Type Natriuretic Peptide and Functional/Cognitive Parameters in Discharged Congestive Heart Failure Patients. International Journal of Endocrinology, 2015; pp 7.
  9. Tsutamoto TA, Wada A, Maeda K, et al. Plasma brain natriuretic peptide level as a biochemical marker of morbidity and mortality in patients with asymptomatic or minimally symptomatic left ventricular dysfunction: comparison with plasma angiotensin II and endothelin. Eur Heart J 1999;20:1799-1807.
  10. John J.V. McMurray et al, ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012, European Heart Journal 2012;33:1787-1847.
  11. Chow SL, Maisel AS, Anand I, et al. Role of Biomarkers for the Prevention, Assessment, and Management of Heart Failure: A Scientific Statement from the American Heart Association. Circulation 2017;Apr 26:[Epub ahead of print].
  12. Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2013;62:e147-239.
  13. Xin W, Lin Z, Mi S, Does B-type natriuretic peptide-guided therapy improve outcomes in patients with chronic heart failure? A systematic review and meta-analysis of randomized controlled trials, Heart Fail Rev 2015;20:69-80.
  14. De Vecchis R, Esposito C, Di Biase G, et al., B-type natriuretic peptideguided versus symptom-guided therapy in outpatients with chronic heart failure: a systematic review with meta-analysis, J Cardiovasc Med 2014;15:122-134.
  15. Savarese G, Trimarco B, Dellegrottaglie S, et al., Natriuretic peptideguided therapy in chronic heart failure: a meta-analysis of 2,686 patients in 12 randomized trials, PLoS One 2013;8:e58287.
  16. Yancy, CW, Jessup M, Bozkurt B, et al. 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America 2017 July 11;136(2):2.
  17. Biomarkers in heart failure. N Engl J Med 2008;358:2148-2159.
  18. Redfield MM RR, Jaoobsen SJ, et al. Plasma brain natriuretic peptide concentration: impact of age and gender. J Am Coll Cardiol. 2002;40:976-982.
  19. Wang TJ, Larson MG, Levy D, et al. Impact of age and sex on plasma natriuretic peptide levels in healthy adults, American Journal of Cardiology, 2002;90(3):254-258.
  20. Nishikimi T, Okamoto H, Nakamura M, et al. Direct Immunochemiluminescent Assay for proBNP and Total BNP in Human Plasma proBNP and Total BNP Levels in Normal and Heart Failure. PLoS ONE 2013;8(1):e53233.
  21. Veena V, Ganesh M, Santhi S. Correlation between brain-type natriuretic peptide (BNP) levels & left ventricular ejection fraction (LVEF) in heart failure. International Journal of Clinical Biochemistry and Research, 2016;3(4):461-465.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.