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Brain natriuretic peptide and other cardiac markers predicting left ventricular remodeling and function two years
Regina Grybauskiene1, Dovile Karciauskaite, Julija Brazdzionyte
1Institute of Cardiology, Kaunas University of Medicine, Sukileliu 17, 50161 Kaunas, Lithuania. reggryb@med.kmu.lt
Insights
Brain natriuretic peptide levels in the acute phase of myocardial infarction correlate with cardiac injury markers and left ventricular remodeling. These markers may help predict future heart function after heart attack.
Area of Science:
- Cardiology
- Biochemistry
- Medical Diagnostics
Background:
- Left ventricular remodeling is a critical process following myocardial infarction, often leading to heart failure.
- Understanding the early markers of this remodeling is crucial for patient outcomes.
Purpose of the Study:
- To assess biochemical markers of cardiac remodeling post-myocardial infarction.
- To compare these markers with clinical indicators of left ventricular remodeling.
Main Methods:
- Measured brain natriuretic peptide, troponin I, CK, CK-MB, and LDH in 30 acute myocardial infarction patients.
- Assessed brain natriuretic peptide and echocardiographic parameters over 2 years post-MI.
Main Results:
- Brain natriuretic peptide levels correlated with left ventricular geometry and remodeling severity in the acute phase.
- Elevated brain natriuretic peptide, LDH, and troponin I in the acute phase predicted increased left ventricular diameter over 2 years.
Conclusions:
- Acute phase brain natriuretic peptide levels are linked to myocardial injury and left ventricular remodeling.
- Brain natriuretic peptide and troponin I may predict subsequent cardiac function after myocardial infarction.
Background:
Left ventricular remodeling is a complex pathologic process of progressive left ventricular dilatation, leading to dysfunction and heart failure in patients after myocardial infarction.
Objective:
To evaluate biochemical markers, reflecting cardiac remodeling process after first myocardial infarction and compare those markers with clinical characteristics of left ventricular remodeling.
Material And Methods:
Brain natriuretic peptide, troponin I, creatine kinase, creatine kinase MB mass, lactate dehydrogenase levels were measured in 30 patients with acute myocardial infarction on days 1, 2, 3-7 . Brain natriuretic peptide was measured at 3 months, 6 months, and 2 years after myocardial infarction. Echocardiographic parameters of left ventricular remodeling were determined in acute phase (day 1-3), at 3 months, 6 months, and 2 years after MI.
Results:
In acute phase, brain natriuretic peptide level progressively increased according to worsening of left ventricular geometry: in normal left ventricle geometry group, brain natriuretic peptide level was 84.1 (58.7-121) pg/mL, in concentric remodeling group - 125 (69.2-165) pg/mL, in concentric hypertrophy group - 128 (74-368) pg/mL, and in eccentric hypertrophy group - 470 (459-494) pg/mL, P=0.02. Patients who had increased left ventricular end diastolic diameter index during 2-year period had higher brain natriuretic peptide level in the acute phase (584 (249-865) pg/mL vs. 120 (67-202) pg/mL, P=0.04) and also higher peak lactate dehydrogenase and troponin I levels.
Conclusions:
Brain natriuretic peptide level in acute phase of myocardial infarction is strongly associated with the markers of myocardial injury and related to left ventricular geometry changes and remodeling. Brain natriuretic peptide together with troponin I levels in acute phase of myocardial infarction might be useful in predicting subsequent cardiac function.
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