Abstract
Background: Brain (B‐type) natriuretic peptide (BNP) is known to be secreted predominantly from the myocardium. Brain natriuretic peptide plasma concentrations have been shown to be markedly increased in patients with acute myocardial infarction; however, plasma BNP response during episodes of myocardial ischemia has not been established.
Hypothesis: This study was designed to examine plasma BNP in patients with transient myocardial ischemia induced by inflation of a percutaneous transluminal coronary angioplasty (PTCA) balloon.
Methods: Thirty consecutive patients (26 men and 4 women; mean age 61 years) who underwent PTCA, and another 49 patients (39 men and 10 women; mean age 63 years) who underwent diagnostic coronary angiography were enrolled in this study. Serum BNP concentrations were assayed in all patients.
Results: Plasma BNP was increased significantly with a peak concentration of 66.1 ± 65.2 pg/ml 24 h after PTCA. Coronary angiography did not cause plasma BNP increase (immediately before 30.4 ± 29.0 pg/ml, 24 h after 33.7 ± 30.6 pg/ml). No significant differences were present in hemodynamic parameters measured immediately before and 24 h after PTCA.
Conclusion: Plasma BNP is increased by transient myocardial ischemia induced by PTCA.
Keywords: brain (B‐type) natriuretic peptide, myocardial ischemia, percutaneous transluminal coronary angioplasty, angina pectoris, coronary angiography
Full Text
The Full Text of this article is available as a PDF (532.2 KB).
References
- 1. Sudoh T, Kangawa K, Minamino N, Matsuo H: A new natriuretic peptide in porcine brain. Nature 1988; 118: 131–139 [DOI] [PubMed] [Google Scholar]
- 2. Hosoda K, Nakao K, Mukoyama M, Saito Y, Jougasaki M, Shirakami G, Suga S, Ogawa Y, Yasue H, Imura H: Expression of brain natriuretic peptide gene in human heart. Production in the ventricle. Hypertension 1991; 17: 1152–1156 [DOI] [PubMed] [Google Scholar]
- 3. Ogawa Y, Nakao K, Mukoyama M, Hosoda K, Shirakami G, Arai H, Saito Y, Suga S, Jougasaki M, Imura H: Natriuretic peptides as cardiac hormones in normotensive and spontaneously hypertensive rats. The ventricle is a major site of synthesis and secretion of brain natriuretic peptide. Circ Res 1991; 69: 491–500 [DOI] [PubMed] [Google Scholar]
- 4. Mukoyama M, Nakao K, Hosoda K, Suga S, Saito Y, Ogawa Y, Shirakami D, Jougasaki M, Obata K, Yasue H: Brain natriuretic peptide as a novel cardiac hormone in humans: Evidence for an exquisite dual natriuretic peptide system, atrial natriuretic peptide and brain natriuretic peptide. J Clin Invest 1991; 87: 1402–1414 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5. Yasue H, Yoshimura M, Sumida H, Kikuta K, Kugiyama K, Jougasaki M, Ogawa H, Okumura K, Mukoyama M, Nakao K: Localization and mechanism of secretion of B‐type natriuretic peptide in comparison with those of A‐type natriuretic peptide in normal subjects and patients with heart failure. Circulation 1994; 90: 195–203 [DOI] [PubMed] [Google Scholar]
- 6. Yoshibayashi M, Kamiya T, Saito Y, Matsuo H: Increased plasma levels of brain natriuretic peptide in hypertrophic cardiomyopathy. N Engl J Med 1993; 329: 464–469 [DOI] [PubMed] [Google Scholar]
- 7. Hasegawa K, Fujiwara H, Doyama K, Miyamae M, Fujiwara T, Suga S, Mukoyama M, Nakao K, Imura H, Sasayama S: Ventricular expression of brain natriuretic peptide in hypertrophic cardiomyopathy. Circulation 1993; 88: 372–380 [DOI] [PubMed] [Google Scholar]
- 8. LaPointe MC, Sitkins JR: Phorbol ester stimulates the synthesis and secretion of brain natriuretic peptide from neonatal rat ventricular cardiocytes: A comparison with the regulation of atrial natriuretic factor. Mol Endcrinol 1993; 7: 1284–1296 [DOI] [PubMed] [Google Scholar]
- 9. Hanford DS, Thuerauf DJ, Murray SF, Glembotski CC: Brain natriuretic peptide is induced by α1‐adrenergic agonists as a primary response gene. J Biol Chem 1994; 269: 26227–26233 [PubMed] [Google Scholar]
- 10. Nakagawa O, Ogawa Y, Itoh H, Suga S, Komatsu Y, Kishimoto I, Nishino K, Yoshimasa T, Nakao K: Rapid transcriptional activation and early mRNA turnover of brain natriuretic peptide in cardiocyte hypertrophy. Evidence for brain natriuretic peptide as an “emergency” cardiac hormone against ventricular overload. J Clin Invest 1995; 96: 1280–1287 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11. Mukoyana M, Nakao K, Obata K, Jougasaki M, Yoshimura M, Morita E, Hosoda K, Suga S, Ogawa Y, Yasue H, Imura H: Augmented secretion of brain natriuretic peptide in acute myocardial infarction. Biochem Biophys Res Commun 1991: 180; 431–436 [DOI] [PubMed] [Google Scholar]
- 12. Morita E, Yasue H, Yoshimura M, Ogawa H, Jougasaki M, Matsumura T, Mukoyama M, Nakao K: Increased plasma levels of brain natriuretic peptide in patients with acute myocardial infarction. Circulation 1993; 88: 82–91 [DOI] [PubMed] [Google Scholar]
- 13. Horio T, Shimada K, Kohno M, Yoshimura M, Kawarabayashi T, Yasunari K, Murakami K, Yokokawa K, Ikeda M, Fukui T, Takeda T: Serial changes in atrial and brain natriuretic peptides in patients with acute myocardial infarction treated with early coronary angioplasty. Am Heart J 1993; 126: 293–299 [DOI] [PubMed] [Google Scholar]
- 14. Arakawa N, Nakamura M, Aoki H, Hiramori K: Plasma brain natriuretic peptide concentrations predict survival after acute myocardial infarction. J Am Coll Cardiol 1996; 27: 1656–1661 [DOI] [PubMed] [Google Scholar]
- 15. Yasue H, Yoshimura M, Jougasaki M, Itoh H, Suga S, Ogawa Y, Nakao K: Plasma levels of brain natriuretic peptide in normal subjects and patients with chronic heart failure: Measurement by immunoradiometric assay (IRMA). Horm Clin 1993; 41: 397–403 [Google Scholar]
- 16. Yasue H, Yoshimura M, Jougasaki M, Itoh H, Suga S, Ogawa Y, Nakao K: Plasma levels of brain natriuretic peptide in patients with acute myocardial infarction: Measurement by immunoradiometric assay (IRMA). Horm Clin 1993; 41: 405–409 [Google Scholar]
- 17. Kikuta K, Yasue H, Yoshimura M, Morita E, Sumida H, Kato H, Kugiyama K, Ogawa H, Okumura K, Ogawa Y, Nakao K: Increased plasma levels of B‐type natriuretic peptide in patients with unstable angina. Am Heart J 1996; 132: 101–107 [DOI] [PubMed] [Google Scholar]
- 18. Wallen T, Landahl S, Hedner T, Saito Y, Masuda I, Nakao K: Brain natriuretic peptide in an elderly population. J Intern Med 1997; 242: 307–311 [DOI] [PubMed] [Google Scholar]
- 19. Arad M, Ella Elazar, Avraham Shotan, Rodica Klein, Babeth Rabinowitz: Brain atrial natriuretic peptide in patients with ischemic heart disease with and without heart failure. Cardiology 1996:87;12–17 [DOI] [PubMed] [Google Scholar]
- 20. Selvais PL, Donckier JE, Robert A, Laloux O, van Liden F, Ahn S, Ketelslegers JM, Rousseau MF: Cardiac natriuretic peptides for diagnosis and risk stratification in heart failure: Influence of left ventricular dysfunction and coronary artery disease on cardiac hormonal activation. Eur J Clin Invest 1998; 28: 636–642 [DOI] [PubMed] [Google Scholar]
- 21. Yoshimura M, Yasue H, Okamura K, Ogawa H, Jougasaki M, Mukoyama M, Nakao K, Imura H: Different secretion patterns of atrial natriuretic peptide and brain natriuretic peptide in patients with congestive heart failure. Circulation 1993; 87: 464–469 [DOI] [PubMed] [Google Scholar]
- 22. Yasue H, Yoshimura M, Sumida H, Kikuta K, Kugiyama K, Jougasaki M, Ogawa H, Okumura K, Mukoyama M, Nakao K: Localization and mechanism of secretion of B‐type natriuretic peptide in comparison with those of A‐type natriuretic peptide in normal subjects and patients with heart failure. Circulation 1994; 90: 195–203 [DOI] [PubMed] [Google Scholar]
- 23. Jensen KT, Carstens J, Ivarsen P, Pedersen EB: A new, fast and reliable radioimmunoassay of brain natriuretic peptide in human plasma. Reference values in healthy subjects and in patients with different diseases. Scand J Lab Invest 1997; 57: 529–540 [DOI] [PubMed] [Google Scholar]
- 24. Noll B, Goke B, Simon B, Maisch B: Cardiac natriuretic peptide hormones during cardiac pacemakers stimulation and left heart catheterization. Clin Invest 1992; 70: 1057–1060 [DOI] [PubMed] [Google Scholar]
- 25. Hama N, Itoh H, Shirakami G, Nakagawa O, Suga S, Ogawa Y, Izuru M, Nakanishi K, Yoshimura T, Yukiya H, Yamaguchi M, Hori R, Yasue H, Nakao K: Rapid ventricular induction of brain natriuretic peptide gene expression in experimental acute myocardial infarction. Circulation 1995; 92: 1558–1564 [DOI] [PubMed] [Google Scholar]
- 26. Ardehali A, Ports TA: Myocardial oxygen supply and demand. Chest 1990; 98: 699–705 [DOI] [PubMed] [Google Scholar]
- 27. Dohen M, Rentrop PK: Limitation of myocardial ischemia by collateral circulation during sudden controlled coronary artery occlusion in human subjects: A prospective study. Circulation 1986; 74: 469–476 [DOI] [PubMed] [Google Scholar]
- 28. Mizuno K, Horiuchi K, Matui H, Miyamoto A, Arakawa K, Shibuya T, Kurita A, Nakamura H: Role of coronary collateral vessels during transient coronary occlusion during angioplasty assessed by hemodynamic, electrocardiographic and metabolic changes. J Am Coll Cardiol 1988; 12: 624–628 [DOI] [PubMed] [Google Scholar]
- 29. Kinnunen P, Vuolteenaho O, Ruskoaho H: Mechanisms of atrial and brain natriuretic peptide release from rat ventricular myocardium: Effect of stretching. Endcrinology 1993; 132: 1961–197030. [DOI] [PubMed] [Google Scholar]
- 30. Magga J, Vuolteenaho O, Marttila M, Ruskoaho H: Endothelin‐1 is involved in stretch‐induced early activation of B‐type natriuretic peptide gene expression in atrial but not in ventricular myocytes. Acute effects of mixed ETA/ETB and ATI receptor antagonists in vivo and in vitro. Circulation 1997; 96: 3053–3062 [DOI] [PubMed] [Google Scholar]
- 31. Liang F, Garadner D: Autocrine/paracrine determinants of strain‐activated brain natriuretic peptide gene expression in cultured cardiac myocytes. J Biol Chem 1998; 273: 14612–14619 [DOI] [PubMed] [Google Scholar]
- 32. Toth M, Vuorinen KH, Vuolteenaho O, Hassinen IE, Uusimaaa P, Leppaluoto J, Ruskoaho H: Hypoxia stimulates release of ANP and BNP from perfused rat ventricular myocardium. Am J Physiol 1994; 266: H11572–H1580 [DOI] [PubMed] [Google Scholar]