摘要
Background: Hypertension is associated with changes in concentrations of vasoactive peptides and procollagen propeptides, but their relationships with left ventricular hypertrophy and cardiac function are unclear. Methods: We measured plasma levels of atrial natriuretic peptide (ANP), its amino terminal propeptide(NT-proANP), B-type natriuretic peptide(BNP), endothelin-1(ET-1), and serum levels of the aminoterminal propeptide of type I procollagen(PINP)-and the aminoterminal propeptide of type III procollagen(PIIINP) and echocardiographic parameters in 97 patients with hypertension in the Anglo-Scandinavian Cardiac Outcomes Trial. Results: Median values (reference values) of the peptides were: ANP 11.2(6.9-14.9)pmol/l, NT-pro-ANP 351(143-311)pmol/l, BNP 1.1(0.4-7.2)pmol/l, ET-18.7(1.2-5.0)pmol/l, PIIINP 2.8(1.7-4.2)μg/l and PINP 29 (19-84)μg/l. Plasma BNP levels in patients with left ventricular hypertrophy(1.2 pmol/l) and patients with echocardiographic signs of diastolic dysfunction(1.5 pmol/l) were greater than those in patients without hypertrophy (0.7 pmol/l) and normal diastolic parameters(0.9 pmol/l) (p < 0.05). BNP was the only biochemical parameter that independently predicted interventricular septal diastolic diameter(p< 0.05), left ventricular mass index(p< 0.01) and ratio of the velocity-time integrals of the E and A waves of the mitral inflow in a stepwise logistic regression analysis(p< 0.05). Conclusions: The results show that BNP reflects the remodelling process in hypertension.
Background: Hypertension is associated with changes in concentrations of vasoactive peptides and procollagen propeptides, but their relationships with left ventricular hypertrophy and cardiac function are unclear. Methods: We measured plasma levels of atrial natriuretic peptide (ANP), its amino terminal propeptide(NT-proANP), B-type natriuretic peptide(BNP), endothelin-1(ET-1), and serum levels of the aminoterminal propeptide of type I procollagen(PINP)-and the aminoterminal propeptide of type III procollagen(PIIINP) and echocardiographic parameters in 97 patients with hypertension in the Anglo-Scandinavian Cardiac Outcomes Trial. Results: Median values (reference values) of the peptides were: ANP 11.2(6.9-14.9)pmol/l, NT-pro-ANP 351(143-311)pmol/l, BNP 1.1(0.4-7.2)pmol/l, ET-18.7(1.2-5.0)pmol/l, PIIINP 2.8(1.7-4.2)μg/l and PINP 29 (19-84)μg/l. Plasma BNP levels in patients with left ventricular hypertrophy(1.2 pmol/l) and patients with echocardiographic signs of diastolic dysfunction(1.5 pmol/l) were greater than those in patients without hypertrophy (0.7 pmol/l) and normal diastolic parameters(0.9 pmol/l) (p < 0.05). BNP was the only biochemical parameter that independently predicted interventricular septal diastolic diameter(p< 0.05), left ventricular mass index(p< 0.01) and ratio of the velocity-time integrals of the E and A waves of the mitral inflow in a stepwise logistic regression analysis(p< 0.05). Conclusions: The results show that BNP reflects the remodelling process in hypertension.
