Estimation of Plasma BNP Levels in Rheumatic Heart Disease Patients at a Tertiary Care Teaching Hospital in Eastern India

Authors

  • Deba Prasad Kar Department of Nephrology, IMS and SUM hospital, Siksha “O” Anusandhan University (Deemed to be), K8, Kalinga nagar, Bhubaneswar-751003, Odisha, India
  • Bandita Dash Department of health centre, National Institute of Science Education and Research, Bhubaneswar, Khurda 752050, Odisha, India, 3Dept Nephrology VMMC and Safdarjang Hospital, New Delhi, 110029, India
  • Anupam Agarwal Dept Nephrology VMMC and Safdarjang Hospital, New Delhi, 110029, India
  • Vijay Pratap Singh Consultant nephrologists Gorakhpur, Uttar Pradesh, India
  • Jatindra Nath Mohanty Medical Research Laboratory, IMS and SUM hospital, Siksha “O” Anusandhan University (Deemed to be), K8, Kalinga nagar,Bhubaneswar-751003, Odisha, India.

DOI:

https://doi.org/10.48165/pvk2fd34

Keywords:

Rheumatic heart disease, Aortic stenosis, Systolic pulmonary artery, BNP

Abstract

Background: Brain natriuretic peptide (BNP) is a cardiac hormone secreted from the ventricular myocardium as a response to ventricular  volume expansion and pressure overload. Rheumatic heart disease is a major health problem, mostly in developing country like India and  particularly in this part of the country. In young age group rheumatic heart disease is the most common cause of cardiac morbidity and  mortality. In this study our aim is to measure BNP levels in patients with RHD and to find out whether BNP concentrations correlate with  clinical and echocardiographic findings. A total of 88 patients with rheumatic valve disease having different type of single or multivalvular  lesions were included in this study. BNP was measured using the chemiluminescence methods (Bayer Centure, Germany) by BNP kit. 2D  Echocardiography with colour Doppler was performed in all patients to assess the severity of the valve disease and for the measurement of  pulmonary artery pressure. The plasma concentrations of BNP were found significantly higher in patients with aortic stenosis than in control  (355.92±204.31pg/ml vs.183.39±93.51pg/ml, p < 0.001). The plasma BNP level was significantly higher in NYHA class IV than in class I  (921.50±301.93 in class I and 125.85±52.88 pg/ml, p < 0.001 in class III). The independent determinants of higher BNP levels were NYHA  functional class and systolic pulmonary artery pressure in multivariate analysis. Along with these results we got all other relative output which  suggested that increased plasma BNP levels in patients with rheumatic heart disease compared with healthy subjects. 

References

1. Sudoch T, Kangawa K, Minamino N, et al. A new natriuretic peptide in porcine brain. Nature 1988;332:78.

2. Mukoyama M, Nakao K, Morii N, et al. Brain natriuretic peptide as a novel cardiac hormone in humans: evidence for an exquisite dual natriuretic peptide system, atrial natriuteric peptide and brain natriuretic peptide. J Clin Invest 1991;87:1402.

3. Yoshimura M, Yasue H, Morita E, et al. Hemodynamic, renal, andhormaonal responses to brain natriuretic peptide infusion in patients with congestive heart failure. Circulation 1991;84:1581.

4. Yasue H, Yoshimura M, Sumida H, et al. Localization and mechanism of B-type natriuretic peptide in comparison with those of A-type natriuretic peptide in normal subjects and patients with heart failure. Circulation 1994;90:195.

5. Nishikimi T, Yoshihara F, Morimoto A, et al. Relationship between left ventricular geometry and natriuretic peptide levels in essential hypertension. Hypertension 1996;28:22.

6. Smith MD. Evaluation of valvular regurgitation by Doppler echocardiography Cardiol Clin 1991;9:193.

7. Perez JE, Ludbrook PA, Ahumada GG. Usefullness of Doppler echocardiography in detecting tricuspid valve stenosis. Am J Cardiol 1985;55:601.

8. Ogawa Y, Nakao K, Mukoyama M, et al. Natriuretic peptide as cardiac hormones in normotensive and spontaneously hypertensive rats: the ventricle is a major site of synthesis and secretion of brain natriuretic peptide. Circ Res 1991;69:491.

9. Nagaya N, Nishikimi T, Okano Y, et al. Plasma brain natriuretic peptide levels increase in proportion to the extent of right ventricular dysfunction in pulmonary hypertension. J Am Coll Cardiol 1998; 31:202.

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Published

2019-11-30

How to Cite

Estimation of Plasma BNP Levels in Rheumatic Heart Disease Patients at a Tertiary Care Teaching Hospital in Eastern India . (2019). Academia Journal of Medicine, 2(2), 73–76. https://doi.org/10.48165/pvk2fd34