PMID- 9767358
OWN - NLM
STAT- MEDLINE
DCOM- 19981203
LR  - 20190826
IS  - 0014-2972 (Print)
IS  - 0014-2972 (Linking)
VI  - 28
IP  - 8
DP  - 1998 Aug
TI  - Cardiac natriuretic peptides for diagnosis and risk stratification in heart 
      failure: influences of left ventricular dysfunction and coronary artery disease 
      on cardiac hormonal activation.
PG  - 636-42
AB  - BACKGROUND: Cardiac natriuretic peptides are activated in heart failure. However, 
      their diagnostic and prognostic values have not been compared under the routine 
      conditions of an outpatient practice. METHODS: We studied the diagnostic and 
      prognostic value of plasma N- and C-terminal peptides of the atrial natriuretic 
      factor prohormone (N-proANF and ANF respectively) and brain natriuretic peptide 
      (BNP) to evaluate the severity of congestive heart failure (CHF) as reflected by 
      the New York Heart Association (NYHA) classification and to predict its 2-year 
      mortality. Peripheral plasma concentrations of the three natriuretic peptides 
      were measured in 27 normal subjects (CTR), in 32 patients with coronary artery 
      disease (CAD) and normal left ventricular ejection fraction and in 101 patients 
      with chronic CHF in functional classes I and II (n = 61) or III and IV (n = 40). 
      RESULTS: Plasma concentrations of the three peptides increased in the presence of 
      CHF in relation to its severity (P < 0.01). BNP was unable to distinguish CTR 
      from CAD, just as ANF could not differentiate CAD from CHF I-II; only N-proANF 
      displayed a significant and continuous increase from CTR to CAD, CHF I-II and 
      III-IV. Receiver-operating characteristic curves showed better evaluation of the 
      degree of CHF by BNP than by ANF or ejection fraction (P < 0.05). Assessment of 
      the 2-year prognosis revealed that N-proANF and BNP were the best independent 
      predictors of outcome after the NYHA classification. These peptides identify a 
      very high-mortality group. CONCLUSION: Plasma N-proANF and BNP concentrations are 
      good indicators of the severity and prognosis of CHF in an outpatient practice. 
      CAD does not stimulate BNP as long as ventricular dysfunction is not present, 
      although increased N-proANF levels in this setting suggest an early humoral 
      activation.
FAU - Selvais, P L
AU  - Selvais PL
AD  - Diabetes and Nutrition Unit, University of Louvain, Brussels, Belgium.
FAU - Donckier, J E
AU  - Donckier JE
FAU - Robert, A
AU  - Robert A
FAU - Laloux, O
AU  - Laloux O
FAU - van Linden, F
AU  - van Linden F
FAU - Ahn, S
AU  - Ahn S
FAU - Ketelslegers, J M
AU  - Ketelslegers JM
FAU - Rousseau, M F
AU  - Rousseau MF
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Eur J Clin Invest
JT  - European journal of clinical investigation
JID - 0245331
RN  - 0 (Protein Precursors)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - 85637-73-6 (Atrial Natriuretic Factor)
SB  - IM
MH  - Aged
MH  - Atrial Natriuretic Factor/*blood
MH  - Chronic Disease
MH  - Coronary Disease/*complications
MH  - Female
MH  - Heart Failure/*diagnosis/etiology/mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/*blood
MH  - Outpatients
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Prospective Studies
MH  - Protein Precursors/*blood
MH  - Survival Analysis
MH  - Ventricular Dysfunction, Left/*complications
EDAT- 1998/10/10 00:00
MHDA- 1998/10/10 00:01
CRDT- 1998/10/10 00:00
PHST- 1998/10/10 00:00 [pubmed]
PHST- 1998/10/10 00:01 [medline]
PHST- 1998/10/10 00:00 [entrez]
AID - 10.1046/j.1365-2362.1998.00338.x [doi]
PST - ppublish
SO  - Eur J Clin Invest. 1998 Aug;28(8):636-42. doi: 10.1046/j.1365-2362.1998.00338.x.