N-Terminal Pro-B-Type Natriuretic Peptide and Echocardiographic Abnormalities in Severely Obese Patients: Correlation with Visceral Fat

Abstract

B-Type natriuretic peptide (BNP) and its co-released peptide N-terminal propeptide (NT-proBNP) are both secreted mainly by the left cardiac ventricle as a consequence of pressure overload and wall stretch. This situation often occurs in obesity, in which the amount of intraabdominal fat may worsen the severity of morphologic and dynamic cardiac abnormalities detectable by echocardiography (1). Many studies have confirmed NT-proBNP as a sensitive marker for left ventricular hypertrophy and/or asymptomatic left ventricular dysfunction (2)(3), and it is particularly reliable because of its high negative predictive value (4). To our knowledge, however, recent findings on the relationship between NT-proBNP and morphologic and dynamic cardiac abnormalities in obesity are still inconsistent and controversial. Rivera et al. (5) reported lower NT-proBNP concentrations in obese patients with heart failure compared with nonobese patients. Conversely, Hermann-Arnhof et al. (6) found that NT-proBNP concentrations were increased in obese individuals and were comparable to the values for New York Heart Association class I patients. Therefore, to gain further information on the …