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

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    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.
    Issue Date
    2012-11
    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
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    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
    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
    ISSN
    1932-6203
    ae974a485f413a2113503eed53cd6c53
    10.1371/journal.pone.0049259
    Scopus Count
    Collections
    St. Vincent's University Hospital

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