Previous studies have shown that levels of plasma brain natriuretic peptide (BNP) increase in an early phase of acute myocardial infarction. However, the relations between plasma BNP levels and left ventricular remodelling, which occurs long after acute myocardial infarction, are not fully understood. Venous plasma BNP levels were measured 2, 7, 14, 30, 90 and 180 days after the onset of acute myocardial infarction in 21 patients. Left ventricular end-diastolic volume index (EDVI, ml/m2) in acute (5 days) and chronic (6 months) phases were assessed by electron-beam computed tomography using Simpson'S method. The remodelling group (n = 9) was defined by an increase in EDVI ⩾ 5 ml/m2 relative to the baseline value. Plasma BNP levels on days 2, 7, 14, 30 and 90 were significantly higher in the remodelling group than in the non-remodelling group (n = 12, P< 0.05). Sustained elevation of plasma BNP levels was noted from day 2 (61±12 pmol/l) to day 90 (55±12 pmol/l) and significantly decreased on day 180 (24±3 pmol/l) in the remodelling group. In contrast, plasma BNP levels significantly decreased from day 2 (25±4 pmol/l) to day 90 (9±1 pmol/l) and reached a steady level thereafter in the non-remodelling group. Plasma BNP levels on day 7 correlated positively with an increase in EDVI (r = 0.70, P< 0.001) from the acute to chronic phase. More importantly, the sustained elevation of plasma BNP (percentage decrease smaller than 25%) from day 30 to day 90 identified patients in the remodelling group with a sensitivity of 100% and a specificity of 83%. In conclusion, not only the high levels of plasma BNP in an acute phase, but also the sustained elevation of plasma BNP in a chronic phase, may be associated with progressive ventricular remodelling occurring long after acute myocardial infarction.
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February 1999
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Research Article|
February 01 1999
Sustained elevation of plasma brain natriuretic peptide levels associated with progressive ventricular remodelling after acute myocardial infarction
Noritoshi NAGAYA;
Noritoshi NAGAYA
1Department of Internal Medicine, National Cardiovascular Center, 5–7–1 Fujishirodai, Suita, Osaka 565, Japan
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Yoichi GOTO;
1Department of Internal Medicine, National Cardiovascular Center, 5–7–1 Fujishirodai, Suita, Osaka 565, Japan
Correspondence: Dr Y. Goto.
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Toshio NISHIKIMI;
Toshio NISHIKIMI
1Department of Internal Medicine, National Cardiovascular Center, 5–7–1 Fujishirodai, Suita, Osaka 565, Japan
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Masaaki UEMATSU;
Masaaki UEMATSU
*Research Institute, National Cardiovascular Center, 5–7–1 Fujishirodai, Suita, Osaka 565, Japan
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Yuji MIYAO;
Yuji MIYAO
1Department of Internal Medicine, National Cardiovascular Center, 5–7–1 Fujishirodai, Suita, Osaka 565, Japan
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Yoshio KOBAYASHI;
Yoshio KOBAYASHI
1Department of Internal Medicine, National Cardiovascular Center, 5–7–1 Fujishirodai, Suita, Osaka 565, Japan
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Shunichi MIYAZAKI;
Shunichi MIYAZAKI
1Department of Internal Medicine, National Cardiovascular Center, 5–7–1 Fujishirodai, Suita, Osaka 565, Japan
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Seiki HAMADA;
Seiki HAMADA
1Department of Internal Medicine, National Cardiovascular Center, 5–7–1 Fujishirodai, Suita, Osaka 565, Japan
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Sachio KURIBAYASHI;
Sachio KURIBAYASHI
1Department of Internal Medicine, National Cardiovascular Center, 5–7–1 Fujishirodai, Suita, Osaka 565, Japan
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Makoto TAKAMIYA;
Makoto TAKAMIYA
1Department of Internal Medicine, National Cardiovascular Center, 5–7–1 Fujishirodai, Suita, Osaka 565, Japan
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Hisayuki MATSUO;
Hisayuki MATSUO
*Research Institute, National Cardiovascular Center, 5–7–1 Fujishirodai, Suita, Osaka 565, Japan
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Kenji KANGAWA;
Kenji KANGAWA
*Research Institute, National Cardiovascular Center, 5–7–1 Fujishirodai, Suita, Osaka 565, Japan
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Hiroshi NONOGI
Hiroshi NONOGI
1Department of Internal Medicine, National Cardiovascular Center, 5–7–1 Fujishirodai, Suita, Osaka 565, Japan
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Publisher: Portland Press Ltd
Received:
March 06 1998
Revision Received:
June 30 1998
Accepted:
August 12 1998
Online ISSN: 1470-8736
Print ISSN: 0143-5221
The Biochemical Society and the Medical Research Society © 1999
1999
Clin Sci (Lond) (1999) 96 (2): 129–136.
Article history
Received:
March 06 1998
Revision Received:
June 30 1998
Accepted:
August 12 1998
Citation
Noritoshi NAGAYA, Yoichi GOTO, Toshio NISHIKIMI, Masaaki UEMATSU, Yuji MIYAO, Yoshio KOBAYASHI, Shunichi MIYAZAKI, Seiki HAMADA, Sachio KURIBAYASHI, Makoto TAKAMIYA, Hisayuki MATSUO, Kenji KANGAWA, Hiroshi NONOGI; Sustained elevation of plasma brain natriuretic peptide levels associated with progressive ventricular remodelling after acute myocardial infarction. Clin Sci (Lond) 1 February 1999; 96 (2): 129–136. doi: https://doi.org/10.1042/cs0960129
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