Extra-cardiac Factors Could Alter Plasma B-type Natriuretic Peptide Levels Independent of Cardiac Function.

Abstract

The assessment of plasma B-type natriuretic peptide (BNP) levels is used for early detection, diagnosis, assessment of the severity of congestive heart failure (CHF), as well as assessments of the effects of therapy and the prognosis of patients with CHF. However extra-cardiac factors could directly alter plasma BNP levels independent of cardiac function and might alter the relationship between them.We investigated the relationship between the BNP level or it's amelioration and clinical factors, including factors, male gender, age, body mass index (BMI), renal function, degrees of inflammations (serum CRP levels) and echocardiographic parameters in patients with various cardiovascular diseases.From our investigation, plasma BNP levels were affected by extra-cardiac factors and older age, low BMI, renal dysfunction, high serum CRP level, and probably diastolic dysfunction rather than systolic dysfunction act against the amelioration of BNP. In particular, low levels of plasma BNP in patients with high BMI should be carefully considered in order to avoid underestimating the degree of heart failure which was assessed using chest X-rays and plasma BNP levels. In addition, plasma BNP levels increased with the severity of cardiac dysfunction and serum CRP levels, and should therefore be considered to be a collective or total marker for life-threatening conditions including systemic inflammation, and not simply as a marker of cardiac dysfunction in patients with cardiovascular diseases.