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Cardiac tamponade as an independent condition affecting the relationship between the plasma B-type natriuretic

Kosuke Minai1, Kimiaki Komukai, Satoshi Arase

  • 1Division of Cardiology, The Jikei University School of Medicine, 3-25-8 Nishishimbashi, Minato-ku, Tokyo, 105-8461, Japan.

Heart and Vessels
|August 29, 2012
PubMed

Insights

Plasma B-type natriuretic peptide (BNP) levels are often low in cardiac tamponade due to impaired ventricular stretching. Drainage of pericardial fluid significantly increases BNP levels, highlighting cardiac tamponade as a factor in interpreting heart failure severity.

Area of Science:

  • Cardiology
  • Biochemistry

Background:

  • Plasma B-type natriuretic peptide (BNP) levels reflect cardiac function but can be influenced by extracardiac factors, leading to inconsistencies in heart failure assessment.
  • The relationship between plasma BNP and heart failure severity is complex and sometimes appears contradictory.

Purpose of the Study:

  • To investigate plasma BNP levels in patients diagnosed with cardiac tamponade.
  • To evaluate the changes in plasma BNP levels following pericardial drainage.

Main Methods:

  • The study included 14 patients with cardiac tamponade (13 malignant, 1 uremic) who underwent pericardiocentesis.
  • Plasma BNP levels were measured before and 24-48 hours after pericardial fluid drainage.

Main Results:

  • Patients presented with severe heart failure symptoms but had low baseline plasma BNP levels (71.2 ± 11.1 pg/ml).
  • Following pericardial drainage, plasma BNP levels significantly increased to 186.0 ± 22.5 pg/ml (P = 0.0002).

Conclusions:

  • Low plasma BNP levels in cardiac tamponade may result from impaired ventricular stretching.
  • Pericardial drainage leads to a significant rise in plasma BNP, indicating the condition's impact on biomarker levels.
  • Cardiac tamponade should be considered when plasma BNP levels appear inconsistent with clinical signs of heart failure.

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