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B-Type Natriuretic Peptide in Heart Failure With Preserved Ejection Fraction　- Relevance to Age-Related Left

Eisaku Harada1, Yuji Mizuno1, Fumihito Kugimiya1

  • 1Division of Cardiovascular Medicine, Kumamoto Kinoh Hospital, Kumamoto Aging Research Institute.

Circulation Journal : Official Journal of the Japanese Circulation Society
|April 7, 2017
PubMed

Insights

Plasma B-type natriuretic peptide (BNP) levels are lower in heart failure with preserved ejection fraction (HFpEF) and linked to aging-related cardiac remodeling. This contrasts with heart failure with reduced ejection fraction (HFrEF), which shows eccentric hypertrophy.

Area of Science:

  • Cardiology
  • Biomarkers
  • Heart Failure Pathophysiology

Background:

  • Heart failure with preserved ejection fraction (HFpEF) is a growing concern, particularly in aging populations.
  • Plasma B-type natriuretic peptide (BNP) levels correlate with left ventricular (LV) dysfunction severity.
  • Understanding BNP in HFpEF is crucial for elucidating its pathogenesis compared to heart failure with reduced ejection fraction (HFrEF).

Purpose of the Study:

  • To investigate plasma B-type natriuretic peptide (BNP) levels in patients with HFpEF.
  • To compare BNP levels and associated cardiac characteristics between HFpEF and HFrEF.
  • To explore the relationship between BNP and LV remodeling in HFpEF.

Main Methods:

  • A cohort of 468 HFpEF patients and 126 HFrEF patients underwent echocardiography and clinical assessments, including plasma BNP measurement.
  • Demographic and clinical data, including age, sex, blood pressure, and LV parameters (diastolic dimensions, mass index, relative wall thickness), were analyzed.
  • Multiple regression analysis identified predictors of plasma BNP levels.

Main Results:

  • HFpEF patients were older, predominantly female, and had higher systolic and pulse pressures than HFrEF patients.
  • Plasma BNP levels, LV diastolic dimensions, and LV mass index (LVMI) were lower in HFpEF, while relative wall thickness was higher.
  • LVMI, ejection fraction (EF), albumin, C-reactive protein, and uric acid predicted BNP levels.

Conclusions:

  • Plasma BNP levels are lower in HFpEF and associated with aging-related LV concentric remodeling.
  • HFpEF differs from HFrEF, where LV hypertrophy is predominantly eccentric.
  • These findings highlight distinct pathophysiological mechanisms in HFpEF versus HFrEF.
Abstract

Keywords:
B-type natriuretic peptideHeart failure with preserved EFHeart failure with reduced EFLV concentric remodeling/hypertrophyLV diastolic function

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