Turk Kardiyol Dern Ars. 2006; 34(7): 413-418

The relationship between plasma brain natriuretic peptide levels and left ventricular end-diastolic pressure and the extent of coronary artery involvement in chronic coronary artery disease

Nevzat Uslu, Nurten Sayar, Ahmet Karabulut, Zekeriya Nurkalem, Ahmet L. Orhan, Özgür Sürgit, Özer Soylu, Hüseyin Uyarel, İbrahim Sarı, Şevket Görgülü, Mehmet Eren
Dr Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Cardiology Department, Istanbul, Turkey

OBJECTIVES
Recent studies suggest that brain natriuretic peptide (BNP) is associated with the prognosis of coronary heart disease. We studied the relationship between BNP and left ventricular (LV) end-diastolic pressure and the number of involved coronary arteries in patients with chronic coronary artery disease.

STUDY DESIGN
The study included 100 patients (30 women, 70 men; mean age 56 years; range 37 to 78 years) who underwent coronary angiography for definite or suspected coronary artery disease. Before angiography, baseline serum samples were obtained for plasma BNP, and LV end-diastolic pressure was measured. The patients were classified in three groups as normal (n=35), one-vessel disease (n=16) and multivessel disease (n=49).

RESULTS
The incidence of diabetes mellitus and the levels of BNP and fasting blood glucose were significantly higher, and LV end-diastolic pressure and the mean heart rate were significantly increased in multivessel disease. Vessel involvement was significantly correlated with BNP (r=0.463, p<0.001), LV end-diastolic pressure (r=0.745, p<0.001), and fasting blood glucose (r=0.235, p<0.05). Correlation between BNP and LV end-diastolic pressure was highly significant (r= 0.72, p<0.001). Multivariate linear regression analysis showed LV end-diastolic pressure as the only independent determinant of increased BNP levels (r=0.762, p<0.001).

CONCLUSION
Increased plasma BNP levels are associated with increased LV end-diastolic pressure and increased vessel involvement in patients with chronic coronary artery disease.

Keywords: Biological markers/blood, coronary angiography; coronary disease; natriuretic peptide, brain; risk factors; ventricular dysfunction, left

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