Obesity and suppressed B-type natriuretic peptide levels in heart failure
| Autor: | Myung H. Park, Mandeep R. Mehra, Robert L. Scott, Hector O. Ventura, Edward D. Frohlich, Patricia A. Uber, Bobbett C Harris |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty Heart disease medicine.drug_class Statistics as Topic Population Overweight Body Mass Index Coronary artery disease Sex Factors Predictive Value of Tests Internal medicine Natriuretic Peptide Brain medicine Natriuretic peptide Humans Obesity education Aged Heart Failure education.field_of_study Ejection fraction business.industry Age Factors Stroke Volume Middle Aged Louisiana medicine.disease Endocrinology Creatinine Heart failure Multivariate Analysis Cytokines Female medicine.symptom Cardiology and Cardiovascular Medicine business Body mass index Biomarkers |
| Zdroj: | Journal of the American College of Cardiology. 43:1590-1595 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/j.jacc.2003.10.066 |
| Popis: | Objectives This investigation evaluated the relationship between obesity and B-type natriuretic peptide (BNP) in heart failure. Background Obesity is a major risk factor for the development of heart failure, but the precise mechanisms remain uncertain. Physiologically, natriuretic peptides and lipolysis are closely linked. Methods A total of 318 patients with heart failure were evaluated between June 2001 and June 2002. Levels of BNP were compared in obese (body mass index [BMI] ≥30 kg/m 2 ) and nonobese (BMI 2 ) patients with respect to New York Heart Association functional class and lean body weight–adjusted peak aerobic oxygen consumption. In a subset of 36 patients, plasma levels of tumor necrosis factor-alpha, interleukin-6, and soluble intercellular adhesion molecule-1 were measured. Results The population's BMI was 29.4 ± 6.6 kg/m 2 ; 24% were lean (BMI 2 ), 31% overweight (BMI ≥25 to 29.9 kg/m 2 ), and 45% obese (BMI ≥30 kg/m 2 ). Obese patients were younger, more often African American, and more likely to have a history of antecedent hypertension, but less likely to have coronary artery disease and with only a trend toward diabetes mellitus. Levels of BNP were significantly lower in obese than in nonobese subjects (205 ± 22 and 335 ± 39 pg/ml, respectively; p = 0.0007), despite a similar severity of heart failure and cytokine levels. Multivariate regression analysis identified BMI as an independent negative correlate of BNP level. There were no differences in emergency department visits, heart failure hospitalization, or death between the obese and nonobese patients at 12-month follow-up. Conclusions Our investigation indicates that a state of reduced natriuretic peptide level exists in the obese individual with heart failure. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|