Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

It has been reported that plasma atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) levels are elevated in patients with atrial fibrillation (AF). The aim of this study was to investigate the change in these patients after pulmonary vein isolation (PVI). In 66 patients with paroxysmal AF (PAF) and without any structural heart disease, plasma ANP and BNP levels were measured before and 3 months after successful PVI. At baseline, in 14 patients, ANP and BNP levels were elevated, and in 52 patients, only BNP levels were elevated. There were no significant relations between the attack frequency or the duration of PAF episodes and ANP or BNP levels. Neither ANP nor BNP level at baseline was a valid predictor of AF recurrence. Even in 31 patients (47%) with recurrent PAF, attacks of PAF were significantly reduced. In 66 patients with elevated ANP and/or BNP levels at baseline, levels were significantly reduced after PVI independent of PAF recurrence (ANP: 69.0+/-23.0 vs 25.0+/-7.7 pg/ml, p<0.0001; BNP: 58.4+/-50.7 vs 22.5+/-27.1 pg/ml, p<0.0001). In 42 patients without AF recurrences, ANP and BNP levels were reduced to within the normal range. In conclusion, in patients with PAF without any structural heart disease, ANP and/or BNP levels were elevated. In those patients, relief of the AF burden by successful PVI significantly reduced elevated plasma ANP and BNP levels.
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PMID:Plasma atrial natriuretic Peptide and brain natriuretic Peptide levels after radiofrequency catheter ablation of atrial fibrillation. 1676 25

In the normal heart, the endocrine capacity resides in the atria. Atrial myocytes express and secrete natriuretic hormones that regulate fluid homeostasis and blood pressure. But in ventricular disease, atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) gene expression is also activated in ventricular myocytes. Plasma concentrations of natriuretic peptides and their biosynthetic precursors are accordingly increased in patients with marked ventricular dysfunction. In contrast, atrial peptide secretion in ventricular disease has received less attention, and our present understanding of the endocrine atria during ventricular dysfunction is still scarce. Although ventricular disease and increased circulating concentrations are associated, it does not entail that the ventricle is the sole or even the main source in all types of heart disease. Clearly, the endocrine atria are also active in heart failure. Plasma measurement of cardiac natriuretic peptides and their molecular precursors can perhaps help us to discriminate when, where and how.
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PMID:Atrial secretion of B-type natriuretic peptide. 1678 47

Pharmacologic support of the failing neonatal heart to maintain cardiac output, which is vital for sufficient end organ perfusion, is a challenging task for the pediatric intensivist, especially since strategies which have been proven to be effective in adults cannot necessarily be extrapolated to neonates. The unique biochemical properties and structure of the neonatal heart, including the increased non-contractile tissue mass, a lower responsiveness to beta adrenergic agents and the heart rate dependent cardiac output with a limited ability to increase stroke volume, favor some of the new inotropes of the Ca+ sensitizer family. Focusing on the after load reduction, inodilators as phosphodiesterase inhibitors and human brain natriuretic peptide offer treatment options for the neonatal myocardium. Additionally, thyroxine and steroids have been investigated in neonates with low cardiac output after surgery for congenital heart disease. Gene therapy, in particular cardiac-selective gene transfer, might offer perspectives for future support for the neonatal heart. This text reviews some of the most recent pharmacologic strategies targeting the failing myocardium in the critically ill newborn and infant.
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PMID:New inotropic pharmacologic strategies targeting the failing myocardium in the newborn and infant. 1684 28

Arterial hypertension has been associated with increased plasma concentrations of C-reactive protein (CRP) and B-type natriuretic peptide (BNP). This study tested the hypothesis that patients with white coat hypertension have lower plasma CRP and BNP concentrations than those with sustained hypertension. A total of 109 consecutive medical outpatients with never-treated office hypertension underwent ambulatory blood pressure monitoring and blood sampling to determine CRP and BNP concentrations. Patients with treated hypertension, lipid-lowering therapy, renal insufficiency or structural heart disease other than left ventricular hypertrophy were excluded. White coat hypertension was defined as office hypertension associated with mean daytime blood pressure values below 135/85 mmHg. A control group of 48 consecutive, age- and sex-matched patients without office hypertension were recruited during the same period. Twenty-six patients (24%) had white coat hypertension. There were no statistically significant differences in baseline variables between patients with sustained hypertension and white coat hypertensives, except for mean blood pressure values. Mean CRP was 3.2+/-5.1 mg/l in patients with white coat hypertension compared to 3.4+/-4.2 mg/l in those with sustained hypertension (p=0.79). Control patients had significantly lower CRP values than patients with either white coat or sustained hypertension (1.2+/-0.9 mg/l, p=0.002 and p=0.038, respectively). Mean BNP concentrations were 21+/-25 pg/l and 44+/-125 pg/l in white coat and sustained hypertensives, respectively (p=0.36). The plasma concentrations of CRP and BNP did not differ between patients with white coat hypertension and those with sustained hypertension.
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PMID:C-reactive protein and B-type natriuretic peptides in never-treated white coat hypertensives. 1694 Jul 3

There is a substantial need for a diagnostic tool to aid in the early diagnosis of heart failure and in the recognition of those at risk for its development, as well as in guidance of therapy. Testing for amino-terminal pro-brain natriuretic peptide (NT-proBNP) has been recognized to have utility in the diagnosis, prognosis and management of heart failure. In addition, numerous other applications for NT-proBNP testing are now recognized, such as evaluation of patients with heart disease in the absence of heart failure, as well as the diagnostic and prognostic evaluation of patients with acute coronary syndromes or pulmonary thromboembolism.
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PMID:Amino-terminal pro-brain natriuretic peptide: a biomarker for diagnosis, prognosis and management of heart failure. 1700 1

Brain natriuretic peptide or B-type natriuretic peptide (BNP) is a sensitive marker of heart disease. Plasma levels of BNP increase in left ventricular failure and determination of plasma BNP has become a useful tool in the diagnosis of heart failure. Hemodialysis (HD) patients may have elevated plasma levels of BNP, particularly predialysis, that correlate with echocardiographic signs of left ventricular dysfunction. High BNP levels are also a strong predictor of mortality in both nonrenal and HD patients. We studied plasma BNP levels in patients who changed from conventional thrice-weekly dialysis to daily dialysis 6 times a week while maintaining a total weekly time on dialysis of 12 hr. Twelve HD patients, mean age 55 years, had 4 hr of conventional thrice-weekly treatment for 4 weeks. Predialysis and postdialysis blood samples were obtained at the last dialysis. Patients were then dialyzed for 2 hr, 6 times weekly, for 4 weeks (daily dialysis). Again, predialysis and postdialysis blood samples were collected at the last HD. Brain natriuretic peptide plasma concentrations were determined by immunoradiometric assay. Predialysis BNP levels decreased from 194+/-51 ng/L (68+/-19 pmol/L; mean+SE) during thrice-weekly HD to 113+/-45 ng/L (41+/-18 pmol/L; p = 0.001) after 4 weeks on daily dialysis. With thrice-weekly HD, predialysis BNP levels were higher than postdialysis levels: 120+/-26 ng/L (39+/-8 pmol/L; p = 0.059). With daily dialysis, predialysis BNP levels did not differ significantly from postdialysis levels. Elevated predialysis plasma levels of BNP, considered sensitive and early markers of left ventricular dysfunction, decreased when patients were changed from conventional thrice-weekly HD to daily dialysis maintaining total hours of dialysis per week constant. Given the accumulated evidence that BNP is a biomarker of left ventricular dysfunction and can be used for risk stratification and guidance in pharmacotherapy of heart failure, daily dialysis appears to lead to less cardiac distress.
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PMID:Daily dialyses decrease plasma levels of brain natriuretic peptide (BNP), a biomarker of left ventricular dysfunction. 1701 18

Heart failure (HF) is associated with atrial conduction delay. Color tissue Doppler imaging was used to evaluate intra- and interatrial asynchrony in patients with HF, patients with structural heart disease without HF, and controls. Twenty-three controls (mean age 65 +/- 13 years), 29 patients with structural heart disease without HF (mean age 68 +/- 9 years), and 29 patients with HF (mean age 67 +/- 9 years) were studied. Patients had no histories of atrial fibrillation. Echocardiographic color tissue Doppler imaging of the atria was performed. Measurements below the atrioventricular plane were selected on the right atrial (RA) free wall, interatrial septum (IAS), and left atrial (LA) free wall. The time difference from the onset of the P wave to the onset of the A wave at the right atrium (P-RA), the IAS (P-IAS), and the left atrium (P-LA) was measured. Asynchrony was defined as the differences between P-IAS and P-RA (RA asynchrony), P-LA and P-IAS (LA asynchrony), and P-LA and P-RA (interatrial asynchrony). In patients with HF, a significant increase in RA asynchrony was observed compared with controls and patients without HF (30 +/- 21 vs 12 +/- 13 and 14 +/- 15 ms, p <0.001). LA asynchrony was not different (19 +/- 26 vs 25 +/- 13 vs 25 +/- 14 ms, p = NS). Interatrial asynchrony was significantly increased in patients with HF (49 +/- 24 vs 37 +/- 9 and 39 +/- 17 ms, p = 0.04). There were moderate but significant correlations of RA asynchrony with log N-terminal-pro-B-type natriuretic peptide (r = 0.3, p = 0.01) and the ejection fraction (r = -0.4, p <0.001). In conclusion, in patients with HF, significant RA and interatrial asynchrony was documented, evaluated by noninvasive color tissue Doppler imaging. Asynchrony was related to N-terminal-pro-B-type natriuretic peptide and to the ejection fraction.
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PMID:Intra- and interatrial asynchrony in patients with heart failure. 1719 67

Nearly 1/3 of patients with heart failure (HF) fail to respond to cardiac resynchronization therapy (CRT). The purpose of this study was to evaluate the value of preimplantation brain natriuretic peptide (BNP) in predicting the clinical response to CRT. We retrospectively analyzed 164 patients who underwent CRT. Patients with New York Heart Association functional class III or IV HF symptoms despite maximal medical therapy, who were not on inotropic medications, had left ventricular ejection fraction < or =35%, and QRS duration >130 ms were included in the study. CRT response in patients who survived at 6-month follow-up was defined as no HF hospitalization and improvement of > or =1 grades in the New York Heart Association classification. BNP assays were performed before implantation and at 6-month follow-up. Patients had ischemic (47%) or nonischemic (53%) cardiopathy. Responders (n = 107) and nonresponders (n = 57) had similar baseline characteristics. Cardiac death and hospitalization for HF occurred in 5 (4.7%) and 18 (31.6%) patients, respectively. CRT responders compared with nonresponders exhibited higher preimplantation BNP levels (800 +/- 823 vs 335 +/- 348 pg/ml, p = 0.0002) and a significant reduction in the QRS duration after implantation (-6 +/- 34 vs +7 +/- 32 ms, p = 0.048). The preimplantation BNP was the only independent predictor of the CRT response (p = 0.001). A BNP value > or =447 pg/ml demonstrated a sensitivity of 62% and specificity of 79% in identifying CRT response. In a subgroup of 41 patients who underwent Doppler tissue imaging analysis, the preimplantation BNP was higher in patients presenting with intraventricular dyssynchrony (845 +/- 779 vs 248 +/- 290 pg/ml, p = 0.04). In conclusion, the preimplantation BNP value independently predicts CRT response and was superior to QRS duration reduction in identifying CRT responders.
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PMID:Usefulness of preimplantation B-type natriuretic peptide level for predicting response to cardiac resynchronization therapy. 1722 26

cardiac injury occurs frequently after stroke; and the most widely investigated form of neurocardiogenic injury is aneurysmal subarachnoid hemorrhage. Echocardiography and screening for elevated troponin and B-type natriuretic peptide levels may help prognosticate and guide treatment of stroke. Cardiac catheterization is not routinely recommended in subarachnoid hemorrhage patients with left ventricular dysfunction and elevated troponin. The priority should be treatment of the underlying neurologic condition, even in patients with left ventricular dysfunction. Cardiac injury that occurs after subarachnoid hemorrhage appears to be reversible. In contrast to subarachnoid hemorrhage patients, patients with ischemic stroke are more likely to have concomitant significant heart disease. For patients who develop brain death, cardiac evaluation under optimal conditions may help increase the organ donor pool.
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PMID:Neurocardiogenic injury in neurovascular disorders. 1723 52

Cancer therapy has shown terrific progress leading to important reduction of morbidity and mortality of several kinds of cancer. The therapeutic management of oncologic patients includes combinations of drugs, radiation therapy and surgery. Many of these therapies produce adverse cardiovascular complications which may negatively affect both the quality of life and the prognosis. For several years the most common noninvasive method of monitoring cardiotoxicity has been represented by radionuclide ventriculography while other tests as effort EKG and stress myocardial perfusion imaging may detect ischemic complications, and 24-hour Holter monitoring unmask suspected arrhythmias. Also biomarkers such as troponine I and T and B-type natriuretic peptide may be useful for early detection of cardiotoxicity. Today, the widely used non-invasive method of monitoring cardiotoxicity of cancer therapy is, however, represented by Doppler-echocardiography which allows to identify the main forms of cardiac complications of cancer therapy: left ventricular (systolic and diastolic) dysfunction, valve heart disease, pericarditis and pericardial effusion, carotid artery lesions. Advanced ultrasound tools, as Integrated Backscatter and Tissue Doppler, but also simple ultrasound detection of "lung comet" on the anterior and lateral chest can be helpful for early, subclinical diagnosis of cardiac involvement. Serial Doppler echocardiographic evaluation has to be encouraged in the oncologic patients, before, during and even late after therapy completion. This is crucial when using anthracyclines, which have early but, most importantly, late, cumulative cardiac toxicity. The echocardiographic monitoring appears even indispensable after radiation therapy, whose detrimental effects may appear several years after the end of irradiation.
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PMID:Cancer therapy and cardiotoxicity: the need of serial Doppler echocardiography. 1725 24


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