Long-term pattern of brain natriuretic peptide and N-terminal pro brain natriuretic peptide and its determinants in the general population: contribution of age, gender, and cardiac and extra-cardiac factors

Aims The natriuretic peptides BNP and NT‐proBNP are potent cardiac markers, but knowledge of long‐term changes is sparse. We thus quantified determinants of change in BNP and NT‐proBNP in a study of south German residents (KORA). Methods and results A total of 1005 men and women (age 25–74 years, me...

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Published inEuropean journal of heart failure Vol. 15; no. 8; pp. 859 - 867
Main Authors Luchner, Andreas, Behrens, Gundula, Stritzke, Jan, Markus, Marcello, Stark, Klaus, Peters, Annette, Meisinger, Christa, Leitzmann, Michael, Hense, Hans-Werner, Schunkert, Heribert, Heid, Iris M.
Format Journal Article
LanguageEnglish
Published England Blackwell Publishing Ltd 01.08.2013
Subjects
10-year-follow-up
Adrenergic beta-Antagonists - therapeutic use
Adult
Aged
Aging - blood
Biomarkers - blood
Body Mass Index
Cohort Studies
Diabetes Mellitus - blood
Diabetes Mellitus - epidemiology
Echocardiography
Female
Germany - epidemiology
Heart Atria - diagnostic imaging
Heart failure
Heart Ventricles - diagnostic imaging
Humans
Hypertension
Hypertrophy, Left Ventricular - blood
Hypertrophy, Left Ventricular - epidemiology
Longitudinal Studies
LV hypertrophy
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction - blood
Myocardial Infarction - epidemiology
Natriuretic Peptide, Brain - blood
Natriuretic peptides
Organ Size
Peptide Fragments - blood
Regression Analysis
Sex Factors
Heart failure
Hypertension
Echocardiography
LV hypertrophy
10-year-follow-up
Natriuretic peptides
Online AccessGet full text

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Abstract Aims The natriuretic peptides BNP and NT‐proBNP are potent cardiac markers, but knowledge of long‐term changes is sparse. We thus quantified determinants of change in BNP and NT‐proBNP in a study of south German residents (KORA). Methods and results A total of 1005 men and women (age 25–74 years, mean 48 years) underwent physical examination and echocardiography at baseline and at follow‐up after 10 years. The current analysis comprised 877 subjects with dual measurements of BNP and NT‐proBNP. Both markers increased in both sexes (P < 0.001) during the 10‐year follow‐up, and higher levels in women persisted across time (P for sex difference <0.001). Among baseline covariates, predictors for 10‐year change of NT‐proBNP, BNP, or both were age, sex, diabetes status, and heart rate (multivariable regression analysis, each P < 0.05). However, changes of covariates over the 10‐year follow‐up were much stronger determinants. Specifically, incident myocardial infarction, new beta‐blocker medication, and increased cardiac parameters (left atrial diameter, LV end‐diastolic diameter, and LV mass index) were associated with increasing BNP, NT‐proBNP, or both, whereas increased heart rate, haematocrit, and body mass index (BMI) were associated with decreasing BNP and NT‐proBNP (all P < 0.05). Conclusion Next to ageing and sex, a variety of changes in covariates reflecting the sequelae of cardiac remodelling as well as myocardial infarction and diabetes influence long‐term changes of BNP and NT‐proBNP. Of note, diabetes and increased BMI exert opposite effects. For interpretation of individual marker concentrations, a host of covariates needs to be considered, especially in subjects without prevalent or incident cardiac disease.
AbstractList The natriuretic peptides BNP and NT-proBNP are potent cardiac markers, but knowledge of long-term changes is sparse. We thus quantified determinants of change in BNP and NT-proBNP in a study of south German residents (KORA).AIMSThe natriuretic peptides BNP and NT-proBNP are potent cardiac markers, but knowledge of long-term changes is sparse. We thus quantified determinants of change in BNP and NT-proBNP in a study of south German residents (KORA).A total of 1005 men and women (age 25-74 years, mean 48 years) underwent physical examination and echocardiography at baseline and at follow-up after 10 years. The current analysis comprised 877 subjects with dual measurements of BNP and NT-proBNP. Both markers increased in both sexes (P < 0.001) during the 10-year follow-up, and higher levels in women persisted across time (P for sex difference <0.001). Among baseline covariates, predictors for 10-year change of NT-proBNP, BNP, or both were age, sex, diabetes status, and heart rate (multivariable regression analysis, each P < 0.05). However, changes of covariates over the 10-year follow-up were much stronger determinants. Specifically, incident myocardial infarction, new beta-blocker medication, and increased cardiac parameters (left atrial diameter, LV end-diastolic diameter, and LV mass index) were associated with increasing BNP, NT-proBNP, or both, whereas increased heart rate, haematocrit, and body mass index (BMI) were associated with decreasing BNP and NT-proBNP (all P < 0.05).METHODS AND RESULTSA total of 1005 men and women (age 25-74 years, mean 48 years) underwent physical examination and echocardiography at baseline and at follow-up after 10 years. The current analysis comprised 877 subjects with dual measurements of BNP and NT-proBNP. Both markers increased in both sexes (P < 0.001) during the 10-year follow-up, and higher levels in women persisted across time (P for sex difference <0.001). Among baseline covariates, predictors for 10-year change of NT-proBNP, BNP, or both were age, sex, diabetes status, and heart rate (multivariable regression analysis, each P < 0.05). However, changes of covariates over the 10-year follow-up were much stronger determinants. Specifically, incident myocardial infarction, new beta-blocker medication, and increased cardiac parameters (left atrial diameter, LV end-diastolic diameter, and LV mass index) were associated with increasing BNP, NT-proBNP, or both, whereas increased heart rate, haematocrit, and body mass index (BMI) were associated with decreasing BNP and NT-proBNP (all P < 0.05).Next to ageing and sex, a variety of changes in covariates reflecting the sequelae of cardiac remodelling as well as myocardial infarction and diabetes influence long-term changes of BNP and NT-proBNP. Of note, diabetes and increased BMI exert opposite effects. For interpretation of individual marker concentrations, a host of covariates needs to be considered, especially in subjects without prevalent or incident cardiac disease.CONCLUSIONNext to ageing and sex, a variety of changes in covariates reflecting the sequelae of cardiac remodelling as well as myocardial infarction and diabetes influence long-term changes of BNP and NT-proBNP. Of note, diabetes and increased BMI exert opposite effects. For interpretation of individual marker concentrations, a host of covariates needs to be considered, especially in subjects without prevalent or incident cardiac disease.
The natriuretic peptides BNP and NT-proBNP are potent cardiac markers, but knowledge of long-term changes is sparse. We thus quantified determinants of change in BNP and NT-proBNP in a study of south German residents (KORA). A total of 1005 men and women (age 25-74 years, mean 48 years) underwent physical examination and echocardiography at baseline and at follow-up after 10 years. The current analysis comprised 877 subjects with dual measurements of BNP and NT-proBNP. Both markers increased in both sexes (P < 0.001) during the 10-year follow-up, and higher levels in women persisted across time (P for sex difference <0.001). Among baseline covariates, predictors for 10-year change of NT-proBNP, BNP, or both were age, sex, diabetes status, and heart rate (multivariable regression analysis, each P < 0.05). However, changes of covariates over the 10-year follow-up were much stronger determinants. Specifically, incident myocardial infarction, new beta-blocker medication, and increased cardiac parameters (left atrial diameter, LV end-diastolic diameter, and LV mass index) were associated with increasing BNP, NT-proBNP, or both, whereas increased heart rate, haematocrit, and body mass index (BMI) were associated with decreasing BNP and NT-proBNP (all P < 0.05). Next to ageing and sex, a variety of changes in covariates reflecting the sequelae of cardiac remodelling as well as myocardial infarction and diabetes influence long-term changes of BNP and NT-proBNP. Of note, diabetes and increased BMI exert opposite effects. For interpretation of individual marker concentrations, a host of covariates needs to be considered, especially in subjects without prevalent or incident cardiac disease.
Aims The natriuretic peptides BNP and NT‐proBNP are potent cardiac markers, but knowledge of long‐term changes is sparse. We thus quantified determinants of change in BNP and NT‐proBNP in a study of south German residents (KORA). Methods and results A total of 1005 men and women (age 25–74 years, mean 48 years) underwent physical examination and echocardiography at baseline and at follow‐up after 10 years. The current analysis comprised 877 subjects with dual measurements of BNP and NT‐proBNP. Both markers increased in both sexes (P < 0.001) during the 10‐year follow‐up, and higher levels in women persisted across time (P for sex difference <0.001). Among baseline covariates, predictors for 10‐year change of NT‐proBNP, BNP, or both were age, sex, diabetes status, and heart rate (multivariable regression analysis, each P < 0.05). However, changes of covariates over the 10‐year follow‐up were much stronger determinants. Specifically, incident myocardial infarction, new beta‐blocker medication, and increased cardiac parameters (left atrial diameter, LV end‐diastolic diameter, and LV mass index) were associated with increasing BNP, NT‐proBNP, or both, whereas increased heart rate, haematocrit, and body mass index (BMI) were associated with decreasing BNP and NT‐proBNP (all P < 0.05). Conclusion Next to ageing and sex, a variety of changes in covariates reflecting the sequelae of cardiac remodelling as well as myocardial infarction and diabetes influence long‐term changes of BNP and NT‐proBNP. Of note, diabetes and increased BMI exert opposite effects. For interpretation of individual marker concentrations, a host of covariates needs to be considered, especially in subjects without prevalent or incident cardiac disease.
Author Heid, Iris M.
Meisinger, Christa
Leitzmann, Michael
Hense, Hans-Werner
Stark, Klaus
Markus, Marcello
Luchner, Andreas
Stritzke, Jan
Schunkert, Heribert
Behrens, Gundula
Peters, Annette
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  givenname: Iris M.
  surname: Heid
  fullname: Heid, Iris M.
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Keywords Heart failure
Hypertension
Echocardiography
LV hypertrophy
10-year-follow-up
Natriuretic peptides
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WHO MONICA Project Principal Investigators: The World Health OrganizationMONICA Project (monitoring trends and determinants in cardiovascular disease): a major international collaboration J Clin Epidemiol 1988 41 105 114
van den Hurk K Alssema M Kamp O Henry RM Stehouwer CD Diamant M Boomsma F Heine RJ Nijpels G Paulus WJ Dekker JM Slightly elevated B-type natriuretic peptide levels in a non-heart failure range indicate a worse left ventricular diastolic function in individuals with, as compared with individuals without, type 2 diabetes: the Hoorn Study Eur J Heart Fail 2010 12 958 965
Muscari A Berzigotti A Bianchi G Giannoni C Ligabue A Magalotti D Sbano D Zacchini A Zoli M Non-cardiac determinants of NT-proBNP levels in the elderly: relevance of haematocrit and hepatic steatosis Eur J Heart Fail 2006 8 468 476
McMurray JJ Adamopoulos S Anker SD Auricchio A Böhm M Dickstein K Falk V Filippatos G Fonseca C Gomez-Sanchez MA Jaarsma T Køber L Lip GY Maggioni AP Parkhomenko A Pieske BM Popescu BA Rønnevik PK Rutten FH Schwitter J Seferovic P Stepinska J Trindade PT Voors AA Zannad F Zeiher A Bax JJ Baumgartner H Ceconi C Dean V Deaton C Fagard R Funck-Brentano C Hasdai D Hoes A Kirchhof P Knuuti J Kolh P McDonagh T Moulin C Popescu BA Reiner Z Sechtem U Sirnes PA Tendera M Torbicki A Vahanian A Windecker S McDonagh T Sechtem U Bonet LA Avraamides P Ben Lamin HA Brignole M Coca A Cowburn P Dargie H Elliott P Flachskampf FA Guida GF Hardman S Iung B Merkely B Mueller C Nanas JN Nielsen OW Orn S Parissis JT Ponikowski P Task Force for the Diagnosis Treatment of Acute Chronic Heart Failure 2012 of the European Society of CardiologyESC Committee for Practice Guidelines. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC Eur J Heart Fail 2012 14 803 869
Devereux RB Reichek N Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method Circulation 1977 55 613 618
McDonagh TA Robb SD Murdoch DR Morton JJ Ford I Morrison CE Tunstall-Pedoe H McMurray JJ Dargie HJ Biochemical detection of left-ventricular systolic dysfunction Lancet 1998 351 9 13
Luchner A Burnett JC Jr Jougasaki M Hense HW Heid IM Muders F Riegger GA Schunkert H Evaluation of brain natriuretic peptide as marker of left ventricular dysfunction and hypertrophy in the population J Hypertens 2000 18 1121 1128
Hildebrandt P Collinson PO Doughty RN Fuat A Gaze DC Gustafsson F Januzzi J Rosenberg J Senior R Richards M Age-dependent values of N-terminal pro-B-type natriuretic peptide are superior to a single cut-point for ruling out suspected systolic dysfunction in primary care Eur Heart J 2010 31 1881 1889
Luchner A Muders F Dietl O Friedrich E Blumberg F Protter AA Riegger GA Elsner D Differential expression of cardiac ANP and BNP in a rabbit model of progressive left ventricular dysfunction Cardiovasc Res 2001 51 601 607
Schiller NB Shah PM Crawford M DeMaria A Devereux R Feigenbaum H Gutgesell H Reichek N Sahn D Schnittger I Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms J Am Soc Echocardiogr 1989 2 358 367
Kambayashi Y Nakao K Mukoyama M Saito Y Ogawa Y Shiono S Inouye K Yoshida N Imura H Isolation and sequence determination of human brain natriuretic peptide in human atrium FEBS Lett 1990 259 341 345
Bertoni AG Wagenknecht LE Kitzman DW Marcovina SM Rushing JT Espeland MA Brain Natriuretic Peptide Subgroup of the Look AHEAD Research GroupImpact of the look AHEAD intervention on NT-pro brain natriuretic peptide in overweight and obese adults with diabetes. Obesity (Silver Spring) 2012 20 1511 1518
Hogenhuis J Voors AA Jaarsma T Hoes AW Hillege HL Kragten JA van Veldhuisen DJ Anaemia and renal dysfunction are independently associated with BNP and NT-proBNP levels in patients with heart failure Eur J Heart Fail 2007 9 787 794
Cockroft D Gault M Prediction of creatinine clearance from serum creatinine Nephron 1976 16 31 41
Stritzke J Markus MR Duderstadt S Lieb W Luchner A Döring A Keil U Hense HW Schunkert H MONICA/KORA InvestigatorsThe aging process of the heart: obesity is the main risk factor for left atrial enlargement during aging the MONICA/KORA (monitoring of trends and determinations in cardiovascular disease/cooperative research in the region of Augsburg) study J Am Coll Cardiol 2009 54 1982 1989
Wang TJ Larson MG Levy D Benjamin EJ Leip EP Wilson PW Vasan RS Impact of obesity on plasma natriuretic peptide levels Circulation 2004 109 594 600
Luchner A Hengstenberg C Lowel H Trawinski J Baumann M Riegger GA Schunkert H Holmer S N-terminal pro-brain natriuretic peptide after myocardial infarction: a marker of cardio-renal function Hypertension 2002 39 99 104
Daniels LB Clopton P Bhalla V Krishnaswamy P Nowak RM McCord J Hollander JE Duc P Omland T Storrow AB Abraham WT Wu AH Steg PG Westheim A Knudsen CW Perez A Kazanegra R Herrmann HC McCullough PA Maisel AS How obesity affects the cut-points for B-type natriuretic peptide in the diagnosis of acute heart failure. Results from the Breathing Not Properly Multinational Study Am Heart J 2006 151 999 1005
van den Meiracker AH Lameris TW van de Ven LL Boomsma F Increased plasma concentration of natriuretic peptides by selective beta1-blocker bisoprolol J Cardiovasc Pharmacol 2003 42 462 468
Wold Knudsen C Vik-Mo H Omland T Blood haemoglobin is an independent predictor of B-type natriuretic peptide (BNP) Clin Sci (Lond) 2005 109 69 74
Luchner A Burnett JC Jr Jougasaki M Hense HW Riegger GA Schunkert H Augmentation of the cardiac natriuretic peptides by beta-receptor antagonism: evidence from a population-based study J Am Coll Cardiol 1998 321839-1344
Davis ME Richards AM Nicholls MG Yandle TG Frampton CM Troughton RW Introduction of metoprolol increases plasma B-type cardiac natriuretic peptides in mild, stable heart failure Circulation 2006 113 977 985
Keil U Stieber J Doring A Chambless L Hartel U Filipiak B Hense HW Tietze M Gostomzyk JG The cardiovascular risk factor profile in the study area Augsburg. Results from the first MONICA survey 1984/85 Acta Med Scand Suppl 1988 728 119 128
Beer S Golay S Bardy D Feihl F Gaillard RC Bachmann C Waeber B Ruiz J Increased plasma levels of N-terminal brain natriuretic peptide (NT-proBNP) in type 2 diabetic patients with vascular complications Diabetes Metab 2005 31 567 573
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References_xml – reference: McMurray JJ Adamopoulos S Anker SD Auricchio A Böhm M Dickstein K Falk V Filippatos G Fonseca C Gomez-Sanchez MA Jaarsma T Køber L Lip GY Maggioni AP Parkhomenko A Pieske BM Popescu BA Rønnevik PK Rutten FH Schwitter J Seferovic P Stepinska J Trindade PT Voors AA Zannad F Zeiher A Bax JJ Baumgartner H Ceconi C Dean V Deaton C Fagard R Funck-Brentano C Hasdai D Hoes A Kirchhof P Knuuti J Kolh P McDonagh T Moulin C Popescu BA Reiner Z Sechtem U Sirnes PA Tendera M Torbicki A Vahanian A Windecker S McDonagh T Sechtem U Bonet LA Avraamides P Ben Lamin HA Brignole M Coca A Cowburn P Dargie H Elliott P Flachskampf FA Guida GF Hardman S Iung B Merkely B Mueller C Nanas JN Nielsen OW Orn S Parissis JT Ponikowski P Task Force for the Diagnosis Treatment of Acute Chronic Heart Failure 2012 of the European Society of CardiologyESC Committee for Practice Guidelines. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC Eur J Heart Fail 2012 14 803 869
– reference: Cockroft D Gault M Prediction of creatinine clearance from serum creatinine Nephron 1976 16 31 41
– reference: Muscari A Berzigotti A Bianchi G Giannoni C Ligabue A Magalotti D Sbano D Zacchini A Zoli M Non-cardiac determinants of NT-proBNP levels in the elderly: relevance of haematocrit and hepatic steatosis Eur J Heart Fail 2006 8 468 476
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– reference: Kambayashi Y Nakao K Mukoyama M Saito Y Ogawa Y Shiono S Inouye K Yoshida N Imura H Isolation and sequence determination of human brain natriuretic peptide in human atrium FEBS Lett 1990 259 341 345
– reference: van den Hurk K Alssema M Kamp O Henry RM Stehouwer CD Diamant M Boomsma F Heine RJ Nijpels G Paulus WJ Dekker JM Slightly elevated B-type natriuretic peptide levels in a non-heart failure range indicate a worse left ventricular diastolic function in individuals with, as compared with individuals without, type 2 diabetes: the Hoorn Study Eur J Heart Fail 2010 12 958 965
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– reference: WHO MONICA Project Principal Investigators: The World Health OrganizationMONICA Project (monitoring trends and determinants in cardiovascular disease): a major international collaboration J Clin Epidemiol 1988 41 105 114
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SSID ssj0017002
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Snippet Aims The natriuretic peptides BNP and NT‐proBNP are potent cardiac markers, but knowledge of long‐term changes is sparse. We thus quantified determinants of...
The natriuretic peptides BNP and NT-proBNP are potent cardiac markers, but knowledge of long-term changes is sparse. We thus quantified determinants of change...
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pubmed
crossref
wiley
istex
SourceType Aggregation Database
Index Database
Enrichment Source
Publisher
StartPage 859
SubjectTerms 10-year-follow-up
Adrenergic beta-Antagonists - therapeutic use
Adult
Aged
Aging - blood
Biomarkers - blood
Body Mass Index
Cohort Studies
Diabetes Mellitus - blood
Diabetes Mellitus - epidemiology
Echocardiography
Female
Germany - epidemiology
Heart Atria - diagnostic imaging
Heart failure
Heart Ventricles - diagnostic imaging
Humans
Hypertension
Hypertrophy, Left Ventricular - blood
Hypertrophy, Left Ventricular - epidemiology
Longitudinal Studies
LV hypertrophy
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction - blood
Myocardial Infarction - epidemiology
Natriuretic Peptide, Brain - blood
Natriuretic peptides
Organ Size
Peptide Fragments - blood
Regression Analysis
Sex Factors
Title Long-term pattern of brain natriuretic peptide and N-terminal pro brain natriuretic peptide and its determinants in the general population: contribution of age, gender, and cardiac and extra-cardiac factors
URI https://api.istex.fr/ark:/67375/WNG-C88GFJ2J-N/fulltext.pdf
https://onlinelibrary.wiley.com/doi/abs/10.1093%2Feurjhf%2Fhft048
https://www.ncbi.nlm.nih.gov/pubmed/23568644
https://www.proquest.com/docview/1413163281
Volume 15
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