Modest elevation in BNP in asymptomatic hypertensive patients reflects sub-clinical cardiac remodeling, inflammation and extracellular matrix changes.

Hdl Handle:
http://hdl.handle.net/10147/291077
Title:
Modest elevation in BNP in asymptomatic hypertensive patients reflects sub-clinical cardiac remodeling, inflammation and extracellular matrix changes.
Authors:
Phelan, Dermot; Watson, Chris; Martos, Ramon; Collier, Patrick; Patle, Anil; Donnelly, Seamas; Ledwidge, Mark; Baugh, John; McDonald, Ken
Affiliation:
Heart Failure Unit, St Vincent's University Hospital, Elm Park, Dublin, Ireland.
Citation:
Modest elevation in BNP in asymptomatic hypertensive patients reflects sub-clinical cardiac remodeling, inflammation and extracellular matrix changes. 2012, 7 (11):e49259 PLoS ONE
Journal:
PloS one
Issue Date:
Nov-2012
URI:
http://hdl.handle.net/10147/291077
DOI:
10.1371/journal.pone.0049259
PubMed ID:
23152884
Additional Links:
http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0049259; http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3495762/pdf/pone.0049259.pdf
Abstract:
In asymptomatic subjects B-type natriuretic peptide (BNP) is associated with adverse cardiovascular outcomes even at levels well below contemporary thresholds used for the diagnosis of heart failure. The mechanisms behind these observations are unclear. We examined the hypothesis that in an asymptomatic hypertensive population BNP would be associated with sub-clinical evidence of cardiac remodeling, inflammation and extracellular matrix (ECM) alterations. We performed transthoracic echocardiography and sampled coronary sinus (CS) and peripheral serum from patients with low (n = 14) and high BNP (n = 27). Peripheral BNP was closely associated with CS levels (r = 0.92, p<0.001). CS BNP correlated significantly with CS levels of markers of collagen type I and III turnover including: PINP (r = 0.44, p = 0.008), CITP (r = 0.35, p = 0.03) and PIIINP (r = 0.35, p = 0.001), and with CS levels of inflammatory cytokines including: TNF-α (r = 0.49, p = 0.002), IL-6 (r = 0.35, p = 0.04), and IL-8 (r = 0.54, p<0.001). The high BNP group had greater CS expression of fibro-inflammatory biomarkers including: CITP (3.8±0.7 versus 5.1±1.9, p = 0.007), TNF-α (3.2±0.5 versus 3.7±1.1, p = 003), IL-6 (1.9±1.3 versus 3.4±2.7, p = 0.02) and hsCRP (1.2±1.1 versus 2.4±1.1, p = 0.04), and greater left ventricular mass index (97±20 versus 118±26 g/m(2), p = 0.03) and left atrial volume index (18±2 versus 21±4, p = 0.008). Our data provide insight into the mechanisms behind the observed negative prognostic impact of modest elevations in BNP and suggest that in an asymptomatic hypertensive cohort a peripheral BNP measurement may be a useful marker of an early, sub-clinical pathological process characterized by cardiac remodeling, inflammation and ECM alterations.
Item Type:
Article In Press
Language:
en
Keywords:
CARDIOVASCULAR DISEASE
MeSH:
Aged; Biological Markers; Coronary Sinus; Extracellular Matrix; Female; Humans; Hypertension; Inflammation; Interleukin-6; Interleukin-8; Male; Natriuretic Peptide, Brain; Ventricular Remodeling
ISSN:
1932-6203

Full metadata record

DC FieldValue Language
dc.contributor.authorPhelan, Dermoten_GB
dc.contributor.authorWatson, Chrisen_GB
dc.contributor.authorMartos, Ramonen_GB
dc.contributor.authorCollier, Patricken_GB
dc.contributor.authorPatle, Anilen_GB
dc.contributor.authorDonnelly, Seamasen_GB
dc.contributor.authorLedwidge, Marken_GB
dc.contributor.authorBaugh, Johnen_GB
dc.contributor.authorMcDonald, Kenen_GB
dc.date.accessioned2013-05-14T13:12:12Z-
dc.date.available2013-05-14T13:12:12Z-
dc.date.issued2012-11-
dc.identifier.citationModest elevation in BNP in asymptomatic hypertensive patients reflects sub-clinical cardiac remodeling, inflammation and extracellular matrix changes. 2012, 7 (11):e49259 PLoS ONEen_GB
dc.identifier.issn1932-6203-
dc.identifier.pmid23152884-
dc.identifier.doi10.1371/journal.pone.0049259-
dc.identifier.urihttp://hdl.handle.net/10147/291077-
dc.description.abstractIn asymptomatic subjects B-type natriuretic peptide (BNP) is associated with adverse cardiovascular outcomes even at levels well below contemporary thresholds used for the diagnosis of heart failure. The mechanisms behind these observations are unclear. We examined the hypothesis that in an asymptomatic hypertensive population BNP would be associated with sub-clinical evidence of cardiac remodeling, inflammation and extracellular matrix (ECM) alterations. We performed transthoracic echocardiography and sampled coronary sinus (CS) and peripheral serum from patients with low (n = 14) and high BNP (n = 27). Peripheral BNP was closely associated with CS levels (r = 0.92, p<0.001). CS BNP correlated significantly with CS levels of markers of collagen type I and III turnover including: PINP (r = 0.44, p = 0.008), CITP (r = 0.35, p = 0.03) and PIIINP (r = 0.35, p = 0.001), and with CS levels of inflammatory cytokines including: TNF-α (r = 0.49, p = 0.002), IL-6 (r = 0.35, p = 0.04), and IL-8 (r = 0.54, p<0.001). The high BNP group had greater CS expression of fibro-inflammatory biomarkers including: CITP (3.8±0.7 versus 5.1±1.9, p = 0.007), TNF-α (3.2±0.5 versus 3.7±1.1, p = 003), IL-6 (1.9±1.3 versus 3.4±2.7, p = 0.02) and hsCRP (1.2±1.1 versus 2.4±1.1, p = 0.04), and greater left ventricular mass index (97±20 versus 118±26 g/m(2), p = 0.03) and left atrial volume index (18±2 versus 21±4, p = 0.008). Our data provide insight into the mechanisms behind the observed negative prognostic impact of modest elevations in BNP and suggest that in an asymptomatic hypertensive cohort a peripheral BNP measurement may be a useful marker of an early, sub-clinical pathological process characterized by cardiac remodeling, inflammation and ECM alterations.en_GB
dc.language.isoenen
dc.relation.urlhttp://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0049259en_GB
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3495762/pdf/pone.0049259.pdfen_GB
dc.rightsArchived with thanks to PloS oneen_GB
dc.subjectCARDIOVASCULAR DISEASE-
dc.subject.meshAged-
dc.subject.meshBiological Markers-
dc.subject.meshCoronary Sinus-
dc.subject.meshExtracellular Matrix-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshHypertension-
dc.subject.meshInflammation-
dc.subject.meshInterleukin-6-
dc.subject.meshInterleukin-8-
dc.subject.meshMale-
dc.subject.meshNatriuretic Peptide, Brain-
dc.subject.meshVentricular Remodeling-
dc.titleModest elevation in BNP in asymptomatic hypertensive patients reflects sub-clinical cardiac remodeling, inflammation and extracellular matrix changes.en_GB
dc.typeArticle In Pressen
dc.contributor.departmentHeart Failure Unit, St Vincent's University Hospital, Elm Park, Dublin, Ireland.en_GB
dc.identifier.journalPloS oneen_GB
dc.description.provinceLeinsteren

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