The changes of plasma levels of natriuretic peptides in patients with chronic heart failure

Objective:This study was performed to explore the correlation among plasma levels of natriuretic peptides and the left ventricular function and structure in patients with chronic heart failure(CHF),and to evaluate the value of plasma levels of natriuretic petides in the CHF diagnosis.Method:We enrolled 48 patients with CHF,among them,10 with coronary artery disease,22 with dilated cardiomyopathy,16 with hypertensive heart disease.Accoriding to the New York Heart Association(NYHA) class,15 patients were classified NYHA Ⅱ,24 NYHA Ⅲ,9 NYHA Ⅳ.Plasma levels of atrial and brain and C\|type natriuretic peptides (ANP,BNP,CNP) were measured by radioimmunoassay and immunoradiometric assay in these patients and 10 age and gender\|matched healthy controls.Doppler echocardiography was performed to measure left ventricular function and structure.Result:Plasma levels of ANP and BNP were significantly eleyated in CHF pATIENTS ( P all 0\^01),and levels increased in proportion to the severity of left ventricular dysfunction.In patients with LVEF45%,plasma level of BNP had a negative correlation with LVEF( P 0\^05),both ANP and BNP levels has positive correlations with pulmonary artery systolic pressure ( P 0\^05 or 0\^01),and BNP plasma level had a positive correlation with left ventricular end\|diastolic diameter and left ventricular mass index ( P all 0\^05). However,the CNP plasma level was not significantly elevzted in CHF patients ( P 0\^05).Conclusion:ANP and BNP plasma levels were good markers used to reflect left ventricular function,whereas BNP level was more sensitive and specific and had close relationship with left ventricular structure.Measurement of BNP plasma level was useful to reflect the immediate change of left ventricular function.