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Plasma brain natriuretic peptide in takotsubo cardiomyopathy
Y J Akashi1, H Musha, K Nakazawa
1Department of Cardiology, St Marianna University, Yokohama-city Seibu Hospital, Yokohama, Japan. johnny@marianna-u.ac.jp
Insights
Plasma brain natriuretic peptide (BNP) levels correlate with basal hyperkinesis severity in takotsubo cardiomyopathy. High BNP does not indicate a poor prognosis in these patients, unlike in other cardiac conditions.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Takotsubo cardiomyopathy presents as reversible left ventricular dysfunction mimicking myocardial infarction but lacks coronary lesions.
- Characterized by apical akinesis and basal hyperkinesis, it shows distinct left ventricular morphology.
Purpose of the Study:
- To investigate plasma brain natriuretic peptide (BNP) concentrations in patients diagnosed with takotsubo cardiomyopathy.
- To explore the relationship between BNP levels and specific echocardiographic parameters in this condition.
Main Methods:
- Cardiac catheterization and blood collection for BNP measurement were performed on the first hospital day in ten takotsubo cardiomyopathy patients.
- The deltaBase value, representing the difference in left ventricular diameter between systole and diastole, was measured to assess basal hyperkinesis.
Main Results:
- Coronary angiography confirmed no significant stenosis in any patient.
- Initial ejection fraction averaged 42.2%, cardiac index 1.90 L/min/m², and plasma BNP 522.5 pg/mL.
- Plasma BNP showed a significant correlation with the deltaBase value, indicating a link to basal hyperkinesis severity.
Conclusions:
- The initial deltaBase value serves as a reliable indicator of basal hyperkinesis severity in takotsubo cardiomyopathy.
- Elevated BNP levels in takotsubo cardiomyopathy are not associated with a poor prognosis, distinguishing it from other cardiac diagnoses.
Background:
Takotsubo cardiomyopathy is a reversible left ventricular dysfunction with symptoms resembling acute myocardial infarction, but without coronary lesions. Patients have wall motion abnormalities (apical akinesis and basal hyperkinesis), and characteristic left ventricular morphology.
Aim:
To investigate plasma brain natriuretic peptide (BNP) concentrations in takotsubo cardiomyopathy.
Methods:
Ten consecutive patients with takotsubo cardiomyopathy underwent cardiac catheterization on their first hospital day, and blood was collected to measure BNP. To evaluate acute basal hyperkinesis, the difference in diameter between systole and diastole was measured at 10 mm below the aortic valve (the deltaBase value).
Results:
Coronary angiography revealed no significant stenosis in any patient. Initial ejection fraction was 42.2 +/- 7.3%, cardiac index was 1.90 +/- 0.39 l/min/m(2), and plasma BNP was 522.5 +/- 632.9 pg/ml. Ventricular contraction and the ejection fraction were normalized on echocardiography after 17.9 +/- 6.3 days. BNP was significantly correlated with deltaBase, but not with other cardiac parameters.
Discussion:
Initial deltaBase value seems to be a good indicator of the severity of basal hyperkinesis in patients with takotsubo cardiomyopathy. In contrast to other diagnoses, a high BNP concentration is not associated with a poor prognosis in this condition.
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