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Ichiki T, Cannone V, Scott CG, Iyer SR, Sangaralingham SJ, Bailey KR, Goetze JP, Tsuji Y, Rodeheffer RJ, Burnett JC. Sex-based differences in metabolic protection by the ANP genetic variant rs5068 in the general population. Am J Physiol Heart Circ Physiol 2023; 325:H545-H552. [PMID: 37417873 PMCID: PMC10538992 DOI: 10.1152/ajpheart.00321.2023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/26/2023] [Accepted: 06/30/2023] [Indexed: 07/08/2023]
Abstract
Atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) are produced in the heart and secreted into the circulation. As hormones, both peptides activate the guanylyl cyclase receptor A (GC-A), playing a role in blood pressure (BP) regulation. A significant role for ANP and BNP includes favorable actions in metabolic homeostasis. Sex-based high prevalence of risk factors for cardiovascular disease in males compared with females is well established, but sex-based differences on cardiometabolic protection have not been investigated in relation to ANP (NPPA) and BNP (NPPB) gene variants. We included 1,146 subjects in the general population from Olmsted County, Minnesota. Subjects were genotyped for the ANP gene variant rs5068 and BNP gene variant rs198389. Cardiometabolic parameters and medical records were reviewed. In the presence of the minor allele of rs5068, diastolic BP, creatinine, body mass index (BMI), waist measurement, insulin, and prevalence of obesity and metabolic syndrome were lower, whereas HDL was higher in males with only trends observed in females. We observed no associations of the minor allele with echocardiographic parameters in either males or females. Regarding rs198389 genotype, the minor allele was not associated with any BP, metabolic, renal, or echocardiographic parameters in either sex. In the general community, the minor allele of the ANP gene variant rs5068 is associated with a favorable metabolic phenotype in males. No associations were observed with the BNP gene variant rs198389. These studies support a protective role of the ANP pathway on metabolic function and underscore the importance of sex in relationship to natriuretic peptide responses.NEW & NOTEWORTHY Males are characterized by lower ANP and BNP with greater prevalence of cardiometabolic disease. The ANP genetic variant rs5068 was associated with less metabolic dysfunction in males, whereas no metabolic profile was related to the BNP genetic variant rs198389 in the general population. ANP may play a more biological role in metabolic homeostasis compared with BNP in the general population with greater physiological metabolic actions in males compared with females.
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Affiliation(s)
- Tomoko Ichiki
- Cardiorenal Research Laboratory, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, United States
- Department of Community and General Medicine, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Valentina Cannone
- Cardiorenal Research Laboratory, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, United States
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Christopher G Scott
- Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, United States
| | - Seethalakshmi R Iyer
- Cardiorenal Research Laboratory, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, United States
| | - S Jeson Sangaralingham
- Cardiorenal Research Laboratory, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, United States
| | - Kent R Bailey
- Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, United States
| | - Jens P Goetze
- Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Yoshihisa Tsuji
- Department of Community and General Medicine, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Richard J Rodeheffer
- Cardiorenal Research Laboratory, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, United States
| | - John C Burnett
- Cardiorenal Research Laboratory, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, United States
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2
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Ferrell PD, Oristian KM, Puranam I, Pizzo SV. Serum Pro-N-Cadherin Is a Marker of Subclinical Heart Failure in the General Population. J Am Heart Assoc 2023; 12:e028234. [PMID: 36892069 PMCID: PMC10111553 DOI: 10.1161/jaha.122.028234] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
Background We recently reported aberrant processing and localization of the precursor PNC (pro-N-cadherin) protein in failing heart tissues and detected elevated PNC products in the plasma of patients with heart failure. We hypothesize that PNC mislocalization and subsequent circulation is an early event in the pathogenesis of heart failure, and therefore circulating PNC is an early biomarker of heart failure. Methods and Results In collaboration with the Duke University Clinical and Translational Science Institute's MURDOCK (Measurement to Understand Reclassification of Disease of Cabarrus and Kannapolis) study, we queried enrolled individuals and sampled 2 matched cohorts: a cohort of individuals with no known heart failure at the time of serum collection and no heart failure development in the following 13 years (n=289, cohort A) and a matching cohort of enrolled individuals who had no known heart failure at the time of serum collection but subsequently developed heart failure within the following 13 years (n=307, cohort B). Serum PNC and NT-proBNP (N-terminal pro B-type natriuretic peptide) concentrations in each population were quantified by ELISA. We detected no significant difference in NT-proBNP rule-in or rule-out statistics between the 2 cohorts at baseline. In participants who developed heart failure, serum PNC is significantly elevated relative to those who did not report development of heart failure (P<0.0001). Receiver operating characteristic analyses of PNC demonstrate diagnostic value for subclinical heart failure. Additionally, PNC has diagnostic potential when comparing participants with no reported heart failure risk factors from cohort A to at-risk participants from cohort B over the 13-year follow-up. Participants whose PNC levels measure >6 ng/mL have a 41% increased risk of all-cause mortality independent of age, body mass index, sex, NT-proBNP, blood pressure, previous heart attack, and coronary artery disease (P=0.044, n=596). Conclusions These data suggest that PNC is an early marker of heart failure and has the potential to identify patients who would benefit from early therapeutic intervention.
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Affiliation(s)
| | | | - Ishaan Puranam
- Department of Biomedical Engineering Duke University Pratt School of Engineering Durham NC
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3
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Optimal cut points of N-terminal of the prohormone brain natriuretic peptide (NT-proBNP) in patients with COVID-19. Egypt Heart J 2022; 74:16. [PMID: 35294679 PMCID: PMC8924742 DOI: 10.1186/s43044-022-00253-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/03/2022] [Indexed: 12/23/2022] Open
Abstract
Background COVID19 patients may suffer from multiple cardiovascular complications. Recently, N-terminal of the prohormone brain natriuretic peptide (NT-proBNP) was a potentially independent risk factor for COVID-19 in-hospital death. The present study aimed to find new optimal cut points for NT-proBNP across censored survival failure time outcomes in hospitalized COVID-19 patients. Results This cohort study was conducted on 272 patients with COVID-19 whose initial records were recorded from March 2020 to July 2020. Demographic characteristics, clinical examinations, and laboratory measurements were collected at the beginning of the admission registered in the patient record system located in the hospital. We used the maximally selected rank statistics to determine the optimal cut points for NT-proBNP (the most significant split based on the standardized log-rank test). Survival time was defined as the days from hospital admission to discharge day. In this cohort study, two optimal cut points for NT-proBNP were 331 (pg/mL) and 11,126 (pg/mL) based on a survival model. The adjusted HR of NT-proBNP for in-hospital death was 3.41 (95% CI: 1.22–9.51, P = 0.02) for medium against low category, and 3.84 (95% CI: 1.30–11.57, P = 0.01) for high in comparison with low group. Conclusions We reported a dramatically increased concentration of NT-proBNP among COVID-19 patients without heart failure in both severe and non-severe cases. Moreover, our study showed that a high level of NT-proBNP was highly associated with the prolonged survival time of patients with COVID-19. NT-proBNP is a strong prognostic indicator of in-hospital death in the second week of admission.
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4
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Cannone V, Ledwidge M, Watson C, McKie PM, Burnett JC, McDonald K. STOP-HF Trial: Higher Endogenous BNP and Cardiovascular Protection in Subjects at Risk for Heart Failure. JACC Basic Transl Sci 2021; 6:497-504. [PMID: 34222720 PMCID: PMC8246026 DOI: 10.1016/j.jacbts.2021.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/04/2021] [Accepted: 05/04/2021] [Indexed: 11/23/2022]
Abstract
Among subjects at risk for heart failure (Stage A and B), the minor C allele of the B-type natriuretic peptide (BNP) genetic variant rs198389 is associated with higher circulating levels of BNP. Rs198389 C allele is also associated with lower risk of hypertension, new onset of left ventricular systolic dysfunction, and major adverse cardiovascular events. These data support the role of BNP genetic testing and BNP-based therapy for the prevention of heart failure.
B-type natriuretic peptide (BNP) possesses blood-pressure–lowering, antifibrotic, and aldosterone-suppressing properties. In Stage A and B heart failure, the carriers of the minor C allele of the BNP genetic variant rs198389 have higher circulating levels of BNP and are at decreased risk of hypertension, new-onset left ventricular systolic dysfunction, and hospitalization for major adverse cardiovascular events. Future studies are warranted to investigate the role of BNP genetic testing and BNP-based therapy in the prevention of heart failure.
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Affiliation(s)
- Valentina Cannone
- Cardiorenal Research Laboratory, Division of Circulatory Failure, Department of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota, USA.,Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Mark Ledwidge
- STOP-HF Unit, St Vincent's University Healthcare Group, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
| | - Chris Watson
- UCD Conway Institute, School of Medicine, University College Dublin, Dublin, Ireland.,Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, Northern Ireland
| | - Paul M McKie
- Cardiorenal Research Laboratory, Division of Circulatory Failure, Department of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota, USA
| | - John C Burnett
- Cardiorenal Research Laboratory, Division of Circulatory Failure, Department of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota, USA
| | - Kenneth McDonald
- STOP-HF Unit, St Vincent's University Healthcare Group, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
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Yang Y, Zmuda JM, Wojczynski MK, Thyagarajan B, Christensen K, Cvejkus RK, Kuipers AL. Genetic association analysis of the cardiovascular biomarker: N-terminal fragment of pro-B-type natriuretic peptide (NT-proBNP). PLoS One 2021; 16:e0248726. [PMID: 33720941 PMCID: PMC7959346 DOI: 10.1371/journal.pone.0248726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 03/03/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND NT-proBNP is a biomarker of cardiovascular disease (CVD). Little is known about the heritability and genetic variants associated with NT-proBNP. Therefore, we estimated the heritability of and examined genetic associations of SNPs in the BNP gene region with circulating NT-proBNP and prevalent CVD in 4,331 participants from the Long Life Family Study (LLFS). METHODS AND RESULTS Genotypes of 10 SNPs from the NPPB and NPPA regions that encode BNP and A-type natriuretic peptide, respectively, were tested for association with NT-proBNP and prevalent cardiovascular disease and risk factors. We performed analyses using the Sequential Oligogenic Linkage Analysis (SOLAR) program to account for family relatedness, and adjusted all models for age, sex, and field center. The mean age of the LLFS was 69.8 years (range 24-110) with 55.4% females. NT-proBNP was significantly heritable (h2 = 0.21; P = 4x10-14), and the minor alleles of rs632793 (p<0.001) and rs41300100 (p = 0.05) were independently associated with higher serum NT-proBNP levels. Additionally, the minor allele of rs632793 was significantly and consistently associated with lower prevalent CVD, including blood pressures, independent of NT-proBNP level (all P<0.05). Results for prevalent CVD, but not NT-proBNP levels, showed significant interaction by familial generation. CONCLUSION In this family-based study of subjects with exceptional longevity, we identified several allelic variants in the BNP gene region associated with NT-pro-BNP levels and prevalent CVD.
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Affiliation(s)
- Yuan Yang
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Joseph M. Zmuda
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States of America
- Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Mary K. Wojczynski
- Department of Genetics, Washington University in St Louis, St. Louis, MO, United States of America
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, United States of America
| | - Kaare Christensen
- Department of Epidemiology, Biostatistics and Biodemography, Danish Aging Research Center, University of Southern Denmark, Odense C, Denmark
| | - Ryan K. Cvejkus
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Allison L. Kuipers
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States of America
- * E-mail:
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6
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Tian X, Ma J, Wu Y, Zhang P, Li Q, Zhang H, Wu C. Functional analysis of the brain natriuretic peptide gene for high-altitude adaptation in Tibetan pigs. Gene 2020; 768:145305. [PMID: 33186614 DOI: 10.1016/j.gene.2020.145305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 10/22/2020] [Accepted: 11/05/2020] [Indexed: 11/26/2022]
Abstract
High-altitude adaptation in Tibetan pigs (TP) is associated with positively-selected genes. The brain natriuretic peptide (BNP) gene is critical in the regulation of cardiovascular homeostasis and energy metabolism. The present study was conducted to identify the function of BNP for high-altitude adaptations in TP. RT-qPCR and western blotting results indicated that BNP expression could be upregulated when the pigs (especially for the Tibetan pigs) were raised to high altitude. In the 5' flanking region, three polymorphic sites, A-1964G, C-1780G, and T-940C were detected, and the genotype distribution of C-1780G was significantly different between the highland (TP) and lowland (Diannan small-eared pig; Yorkshire pig) breeds. The site of C-1780G was in active promoter regions identified using the luciferase reporter gene system, and the fragment with allele G had higher transcriptional activity than that with allele C. The TP population had a higher frequency of allele G than the two lowland breeds. Our results collectively demonstrated that the G allele of C-1780G in the BNP gene may be advantageous for high-altitude adaptation in pigs through upregulating BNP expression. Our findings provide information that helps toward a comprehensive understanding of the mechanism underlying the involvement of the BNP gene in high-altitude adaptation.
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Affiliation(s)
- Xiaolong Tian
- National Engineering Laboratory for Animal Breeding, Beijing Key Laboratory for Animal Genetic Improvement, China Agricultural University, Beijing 100193, China
| | - Jun Ma
- National Engineering Laboratory for Animal Breeding, Beijing Key Laboratory for Animal Genetic Improvement, China Agricultural University, Beijing 100193, China
| | - Yijing Wu
- Institute of Animal Science and Veterinary Medicine, Anhui Academy of Agriculture Science, Hefei 230031, China
| | - Pan Zhang
- National Engineering Laboratory for Animal Breeding, Beijing Key Laboratory for Animal Genetic Improvement, China Agricultural University, Beijing 100193, China
| | - Qinggang Li
- Institute of Animal Science and Veterinary Medicine, Anhui Academy of Agriculture Science, Hefei 230031, China
| | - Hao Zhang
- National Engineering Laboratory for Animal Breeding, Beijing Key Laboratory for Animal Genetic Improvement, China Agricultural University, Beijing 100193, China.
| | - Changxin Wu
- National Engineering Laboratory for Animal Breeding, Beijing Key Laboratory for Animal Genetic Improvement, China Agricultural University, Beijing 100193, China
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7
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Abstract
PURPOSE OF REVIEW Heart failure (HF) continues to be a public health burden despite advances in therapy, and the natriuretic peptide (NP) system is clearly of critical importance in this setting, spawning valuable diagnostic and prognostic testing, such as B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-proBNP), as well as current and future therapeutics, including recombinant natriuretic peptides (e.g., carperitide, nesiritide) and recently sacubitril, which inhibits the key clearance mechanism for NPs. This article intends to summarize the existing evidence for the role of NP system genetic variation on cardiovascular phenotypes relevant to HF with particular focus on the potential impact on pharmacologic therapies. RECENT FINDINGS Several genes in NP system have been interrogated, in many cases genetic variation impacting protein quantity and function or related disease states. Recent data supports genetic variants potentially impacting pharmacokinetics or dynamics of medications targeting the pathway. Growing evidence indicates the importance of genetic variation to the functioning of the NP system and its pharmacologic manipulation.
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Affiliation(s)
- Ahmed Abuzaanona
- Department of Internal Medicine, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI, 48202, USA
| | - David Lanfear
- Heart and Vascular Institute, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI, 48202, USA.
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Seidelmann SB, Vardeny O, Claggett B, Yu B, Shah AM, Ballantyne CM, Selvin E, MacRae CA, Boerwinkle E, Solomon SD. An NPPB Promoter Polymorphism Associated With Elevated N-Terminal pro-B-Type Natriuretic Peptide and Lower Blood Pressure, Hypertension, and Mortality. J Am Heart Assoc 2017; 6:JAHA.116.005257. [PMID: 28341776 PMCID: PMC5533018 DOI: 10.1161/jaha.116.005257] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background Elevated B‐type natriuretic peptide (BNP) levels are associated with heart failure and increased mortality in the general population. We investigated rs198389, a functional variant in the promoter region of the BNP gene (NPPB), in patients from the Atherosclerosis Risk in Communities Study to investigate associations with N‐terminal pro‐BNP (NT‐proBNP) levels and outcomes. Methods and Results A total of 11 361 black and white patients with rs198389 genotyping attended visit 1 (aged 45–64 years; 1987–1989), with follow‐up visits occurring every 3 years (visit 2–visit 4, 1990–1999), followed by visit 5 (2011–2013). NT‐proBNP levels were measured at visits 2, 4, and 5. At visit 2, the GG genotype (frequency 18%) was associated with a 41% higher mean plasma level of NT‐proBNP compared with the AA genotype (frequency 34%), with intermediate values observed in AGs (P=4.2×10−52). The GG genotype was associated with reduced systolic blood pressure (−1.6 mm Hg, P=0.006), diastolic blood pressure (−1 mm Hg, P=0.003), antihypertension medication use (odds ratio, 0.85; 95% CI, 0.74–0.97 [P=0.02]), and hypertension (odds ratio, 0.81; 95% CI, 0.72–0.92 [P=0.002]) compared with the AA genotype with intermediate values in AGs. These relationships persisted throughout subsequent visits. After a median follow‐up of 23 years, there were 4031 deaths. With and without covariate adjustment, the GG genotype was associated with modestly lower mortality (hazard ratio, 0.86; 95% CI, 0.78–0.95), primarily reflective of cardiovascular death (hazard ratio, 0.75; 95% CI, 0.61–0.92), and increased residual lifespan of 8 months from 50 years of age (P=0.02) versus AAs. Conclusions The rs198389 G allele in the NPPB promoter is associated with elevated levels of NT‐proBNP throughout adult life, reduced blood pressure, hypertension and cardiovascular mortality, and increased lifespan.
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Affiliation(s)
- Sara B Seidelmann
- Cardiovascular Division, Brigham and Women's Hospital, Boston, MA.,Division of Cardiovascular Imaging, Department of Radiology, Brigham and Women's Hospital, Boston, MA
| | - Orly Vardeny
- Departments of Pharmacy and Medicine, University of Wisconsin-Madison, Madison, WI
| | - Brian Claggett
- Cardiovascular Division, Brigham and Women's Hospital, Boston, MA
| | - Bing Yu
- Epidemiology, Human Genetics & Environmental Sciences, UTHealth School of Public Health, Houston, TX
| | - Amil M Shah
- Cardiovascular Division, Brigham and Women's Hospital, Boston, MA
| | | | - Elizabeth Selvin
- The Johns Hopkins Institute for Clinical and Translational Research, Baltimore, MD
| | - Calum A MacRae
- Cardiovascular Division, Brigham and Women's Hospital, Boston, MA
| | - Eric Boerwinkle
- Epidemiology, Human Genetics & Environmental Sciences, UTHealth School of Public Health, Houston, TX.,Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX
| | - Scott D Solomon
- Cardiovascular Division, Brigham and Women's Hospital, Boston, MA
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9
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Lanfear DE, Li J, Abbas R, She R, Padhukasahasram B, Gupta RC, Langholz D, Tang WHW, Williams LK, Sabbah HN, Chow SL. Genetic Factors Influencing B-type Natriuretic Peptide-Mediated Production of Cyclic Guanosine Monophosphate and Blood Pressure Effects in Heart Failure Patients. J Cardiovasc Transl Res 2015; 8:545-53. [PMID: 26589601 DOI: 10.1007/s12265-015-9660-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 11/06/2015] [Indexed: 12/26/2022]
Abstract
Natriuretic peptides (NPs) represent a critical pathway in heart failure (HF). We explored genetic determinants of pharmacodynamic effects of B-type NP (BNP) and changes in plasma cyclic guanosine monophosphate (cGMP) and blood pressure (BP). HF patients (n = 135) received recombinant human BNP (nesiritide) at standard doses, and plasma cGMP levels were measured at baseline and during infusion. We tested the association of 119 single nucleotide polymorphisms (SNPs) in 4 candidate genes (NPR1, NPR2, NPR3, and membrane metallo-endopeptidase (MME)) with the change in cGMP and BP. Gene-based testing for association of genetic variation with endpoints was significant only for MME. Upon individual SNP testing, two loci in MME were associated with ΔcGMP; another (rs16824656) showed association with BP change. In summary, the pharmacodynamic effects of BNP vary substantially in HF patients and are associated with genetic variation in MME. MME genetic variation may be an important determinant of NP-mediated effects in humans.
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Affiliation(s)
- David E Lanfear
- Heart and Vascular Institute, Henry Ford Hospital, Detroit, MI, USA.
- Department of Internal Medicine, Henry Ford Hospital, Detroit, MI, USA.
- Center for Health Policy and Health Services Research, Henry Ford Hospital, Detroit, MI, USA.
| | - Jia Li
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI, USA
| | - Raza Abbas
- Department of Internal Medicine, Henry Ford Hospital, Detroit, MI, USA
| | - Ricoung She
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI, USA
| | - Badri Padhukasahasram
- Center for Health Policy and Health Services Research, Henry Ford Hospital, Detroit, MI, USA
| | - Ramesh C Gupta
- Heart and Vascular Institute, Henry Ford Hospital, Detroit, MI, USA
- Department of Internal Medicine, Henry Ford Hospital, Detroit, MI, USA
| | | | - W H Wilson Tang
- Heart and Vascular Institute and Center for Clinical Genomics, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - L Keoki Williams
- Department of Internal Medicine, Henry Ford Hospital, Detroit, MI, USA
- Center for Health Policy and Health Services Research, Henry Ford Hospital, Detroit, MI, USA
| | - Hani N Sabbah
- Heart and Vascular Institute, Henry Ford Hospital, Detroit, MI, USA
- Department of Internal Medicine, Henry Ford Hospital, Detroit, MI, USA
| | - Sheryl L Chow
- Western University of Health Sciences, Pomona, CA, USA
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10
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Meroufel DN, Ouhaïbi-Djellouli H, Mediene-Benchekor S, Hermant X, Grenier-Boley B, Lardjam-Hetraf SA, Boulenouar H, Hamani-Medjaoui I, Saïdi-Mehtar N, Amouyel P, Houti L, Goumidi L, Meirhaeghe A. Examination of the brain natriuretic peptide rs198389 single-nucleotide polymorphism on type 2 diabetes mellitus and related phenotypes in an Algerian population. Gene 2015; 567:159-63. [PMID: 25934190 DOI: 10.1016/j.gene.2015.04.073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 04/14/2015] [Accepted: 04/27/2015] [Indexed: 12/24/2022]
Abstract
BACKGROUND In European populations, the NPPB rs198389 single nucleotide polymorphism (SNP) is associated with a reduced risk of type 2 diabetes mellitus (T2DM). We investigated the putative associations between NPPB rs198389, the T2DM risk and quantitative metabolic traits in an Algerian population. METHODS The association analysis was performed as a T2DM case-control study (with 78 cases and 645 controls) nested into the ISOR population-based study. RESULTS The NPPB rs198389 SNP was not associated with T2DM (odds ratio (OR) [95% confidence interval (CI)]=0.73 [0.51-1.04], p=0.08). However, the C allele was associated with lower fasting plasma insulin levels (p=0.05) and a lower homeostatic model assessment insulin resistance index (p=0.05) in non-diabetic individuals. CONCLUSION The NPPB rs198389 SNP might modulate fasting insulin levels in an Algerian population.
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Affiliation(s)
- Djabaria Naïma Meroufel
- Laboratoire de Génétique Moléculaire et Cellulaire, Université des Sciences et de Technologie d'Oran Mohamed Boudiaf, BP 1505, El M'Naouer, 31000 Oran, Algeria.
| | - Hadjira Ouhaïbi-Djellouli
- Laboratoire de Génétique Moléculaire et Cellulaire, Université des Sciences et de Technologie d'Oran Mohamed Boudiaf, BP 1505, El M'Naouer, 31000 Oran, Algeria; Département de Biotechnologie, Faculté des Sciences de la Nature et de la Vie, Université d'Oran, BP 1524, El M'Naouer, 31000 Oran, Algeria.
| | - Sounnia Mediene-Benchekor
- Laboratoire de Génétique Moléculaire et Cellulaire, Université des Sciences et de Technologie d'Oran Mohamed Boudiaf, BP 1505, El M'Naouer, 31000 Oran, Algeria; Département de Biotechnologie, Faculté des Sciences de la Nature et de la Vie, Université d'Oran, BP 1524, El M'Naouer, 31000 Oran, Algeria.
| | - Xavier Hermant
- INSERM, U1167, Institut Pasteur de Lille, Université de Lille, 1 rue du Pr. Calmette, BP 245, F-59019 Lille cedex, France.
| | - Benjamin Grenier-Boley
- INSERM, U1167, Institut Pasteur de Lille, Université de Lille, 1 rue du Pr. Calmette, BP 245, F-59019 Lille cedex, France.
| | - Sarah Aïcha Lardjam-Hetraf
- Laboratoire de Génétique Moléculaire et Cellulaire, Université des Sciences et de Technologie d'Oran Mohamed Boudiaf, BP 1505, El M'Naouer, 31000 Oran, Algeria.
| | - Houssam Boulenouar
- Laboratoire de Génétique Moléculaire et Cellulaire, Université des Sciences et de Technologie d'Oran Mohamed Boudiaf, BP 1505, El M'Naouer, 31000 Oran, Algeria.
| | - Imane Hamani-Medjaoui
- Laboratoire de Génétique Moléculaire et Cellulaire, Université des Sciences et de Technologie d'Oran Mohamed Boudiaf, BP 1505, El M'Naouer, 31000 Oran, Algeria; Caisse Nationale des Assurances Sociales des travailleurs salariés, Clinique Spécialisée en Orthopédie et Rééducation des Victimes des Accidents de Travail, Hai Bouamama (El Hassi) Oran, Algeria.
| | - Nadhira Saïdi-Mehtar
- Laboratoire de Génétique Moléculaire et Cellulaire, Université des Sciences et de Technologie d'Oran Mohamed Boudiaf, BP 1505, El M'Naouer, 31000 Oran, Algeria.
| | - Philippe Amouyel
- INSERM, U1167, Institut Pasteur de Lille, Université de Lille, 1 rue du Pr. Calmette, BP 245, F-59019 Lille cedex, France.
| | - Leïla Houti
- Laboratoire de Génétique Moléculaire et Cellulaire, Université des Sciences et de Technologie d'Oran Mohamed Boudiaf, BP 1505, El M'Naouer, 31000 Oran, Algeria; Faculté de Médecine, Université Djillali Liabes de Sidi Bel Abbes, BP 89, 22000 Sidi-Bel-Abbès, Algeria; Laboratoire des Systèmes d'Information en Santé, Université d'Oran, BP 1524, El M'Naouer, 31000 Oran, Algeria.
| | - Louisa Goumidi
- INSERM, U1167, Institut Pasteur de Lille, Université de Lille, 1 rue du Pr. Calmette, BP 245, F-59019 Lille cedex, France.
| | - Aline Meirhaeghe
- INSERM, U1167, Institut Pasteur de Lille, Université de Lille, 1 rue du Pr. Calmette, BP 245, F-59019 Lille cedex, France.
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11
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Musani SK, Fox ER, Kraja A, Bidulescu A, Lieb W, Lin H, Beecham A, Chen MH, Felix JF, Fox CS, Kao WHL, Kardia SLR, Liu CT, Nalls MA, Rundek T, Sacco RL, Smith J, Sun YV, Wilson G, Zhang Z, Mosley TH, Taylor HA, Vasan RS. Genome-wide association analysis of plasma B-type natriuretic peptide in blacks: the Jackson Heart Study. ACTA ACUST UNITED AC 2015; 8:122-30. [PMID: 25561047 DOI: 10.1161/circgenetics.114.000900] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Numerous experimental studies suggest that B-type natriuretic peptide (BNP) is cardioprotective; however, in clinical studies, higher plasma BNP concentrations have been associated with incident cardiovascular disease and higher left ventricular mass. Genetic association studies may allow us to determine the true causal directions without confounding by compensatory mechanisms. METHODS AND RESULTS We performed a meta-analysis of 2 genome-wide association results from a total of 2790 blacks. We assumed an additive genetic model in an association analysis of imputed 2.5 million single-nucleotide polymorphism dosages with residuals generated from multivariable-adjusted logarithmically transformed BNP controlling for relevant covariates and population stratification. Two loci were genome-wide significant, a candidate gene locus NPPB (rs198389, P=1.18×10(-09)) and a novel missense variant in the KLKB1 locus (rs3733402, P=1.75×10(-11)) that explained 0.4% and 1.9% of variation in log BNP concentration, respectively. The observed increase in BNP concentration was proportional to the number of effect allele copies, and an average of 8.1 pg/mL increase was associated with 2 allele copies. In a companion study, single-nucleotide polymorphisms in this loci were cross-checked with genome-wide association results for the aldosterone/renin ratio in individuals of European ancestry, and rs3733402 was genome-wide significant (P<5.0×10(-8)), suggesting possible shared genetic architecture for these 2 pathways. Other statistically significant relations for these single-nucleotide polymorphisms included the following: rs198389 with systolic blood pressure in blacks (COGENT consortium) and rs198389 and rs3733402 with left ventricular mass in whites (EchoGEN consortium). CONCLUSIONS These findings improve our knowledge of the genetic basis of BNP variation in blacks, demonstrate a possible shared allelic architecture for BNP with aldosterone-renin ratio, and motivate further studies of underlying mechanisms.
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12
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Collins S, Storrow AB, Albert NM, Butler J, Ezekowitz J, Felker GM, Fermann GJ, Fonarow GC, Givertz MM, Hiestand B, Hollander JE, Lanfear DE, Levy PD, Pang PS, Peacock WF, Sawyer DB, Teerlink JR, Lenihan DJ. Early management of patients with acute heart failure: state of the art and future directions. A consensus document from the society for academic emergency medicine/heart failure society of America acute heart failure working group. J Card Fail 2015; 21:27-43. [PMID: 25042620 PMCID: PMC4276508 DOI: 10.1016/j.cardfail.2014.07.003] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 06/28/2014] [Accepted: 07/10/2014] [Indexed: 12/18/2022]
Abstract
Heart failure (HF) afflicts nearly 6 million Americans, resulting in one million emergency department (ED) visits and over one million annual hospital discharges. An aging population and improved survival from cardiovascular diseases is expected to further increase HF prevalence. Emergency providers play a significant role in the management of patients with acute heart failure (AHF). It is crucial that emergency physicians and other providers involved in early management understand the latest developments in diagnostic testing, therapeutics and alternatives to hospitalization. Further, clinical trials must be conducted in the ED in order to improve the evidence base and drive optimal initial therapy for AHF. Should ongoing and future studies suggest early phenotype-driven therapy improves in-hospital and post-discharge outcomes, ED treatment decisions will need to evolve accordingly. The potential impact of future studies which incorporate risk-stratification into ED disposition decisions cannot be underestimated. Predictive instruments that identify a cohort of patients safe for ED discharge, while simultaneously addressing barriers to successful outpatient management, have the potential to significantly impact quality of life and resource expenditures.
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Affiliation(s)
- Sean Collins
- Nashville Veterans Affairs Medical Center and Vanderbilt University, Nashville, Tennessee.
| | | | | | | | | | | | | | | | | | | | | | | | | | - Peter S Pang
- Indiana University School of Medicine, Indianapolis, Indiana
| | | | | | - John R Teerlink
- San Francisco Veterans Affairs Medical Center, University of California, San Francisco, California
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13
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Collins SP, Storrow AB, Levy PD, Albert N, Butler J, Ezekowitz JA, Michael Felker G, Fermann GJ, Fonarow GC, Givertz MM, Hiestand B, Hollander JE, Lanfear DE, Pang PS, Frank Peacock W, Sawyer DB, Teerlink JR, Lenihan DJ. Early management of patients with acute heart failure: state of the art and future directions--a consensus document from the SAEM/HFSA acute heart failure working group. Acad Emerg Med 2015; 22:94-112. [PMID: 25423908 DOI: 10.1111/acem.12538] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Accepted: 08/24/2014] [Indexed: 12/20/2022]
Abstract
Heart failure (HF) afflicts nearly 6 million Americans, resulting in 1 million emergency department (ED) visits and over 1 million annual hospital discharges. The majority of inpatient admissions originate in the ED; thus, it is crucial that emergency physicians and other providers involved in early management understand the latest developments in diagnostic testing, therapeutics, and alternatives to hospitalization. This article discusses contemporary ED management as well as the necessary next steps for ED-based acute HF research.
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Affiliation(s)
- Sean P. Collins
- The Department of Emergency Medicine; Vanderbilt University; Nashville Veterans Affairs Medical Center; Nashville TN
| | - Alan B. Storrow
- The Department of Emergency Medicine; Vanderbilt University; Nashville Veterans Affairs Medical Center; Nashville TN
| | - Phillip D. Levy
- The Department of Emergency Medicine; Wayne State University; Detroit MI
| | - Nancy Albert
- The Division of Cardiology; Cleveland Clinic; Cleveland OH
| | - Javed Butler
- The Division of Cardiology; Emory University; Atlanta GA
| | | | | | - Gregory J. Fermann
- The Department of Emergency Medicine; University of Cincinnati; Cincinnati OH
| | - Gregg C. Fonarow
- The Division of Cardiology; Ronald Reagan-UCLA Medical Center; Los Angeles CA
| | | | - Brian Hiestand
- The Department of Emergency Medicine; Wake Forest University; Winston-Salem NC
| | - Judd E. Hollander
- The Department of Emergency Medicine; Thomas Jefferson University; Philadelphia PA
| | | | - Peter S. Pang
- The Department of Emergency Medicine; Northwestern University; Chicago IL
| | - W. Frank Peacock
- The Department of Emergency Medicine; Baylor University; Houston TX
| | - Douglas B. Sawyer
- The Department of Emergency Medicine; Vanderbilt University; Nashville Veterans Affairs Medical Center; Nashville TN
| | - John R. Teerlink
- The Division of Cardiology; San Francisco Veterans Affairs Medical Center; University of California at San Francisco; San Francisco CA
| | - Daniel J. Lenihan
- The Division of Cardiology; Vanderbilt University; Nashville Veterans Affairs Medical Center; Nashville TN
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14
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Minai K, Ogawa T, Kawai M, Komukai K, Tanaka T, Ogawa K, Nagoshi T, Arase S, Morimoto S, Inoue Y, Sekiyama H, Urabe A, Matsuo S, Hongo K, Yoshimura M. The plasma B-type natriuretic peptide levels are low in males with stable ischemic heart disease (IHD) compared to those observed in patients with non-IHD: a retrospective study. PLoS One 2014; 9:e108983. [PMID: 25360594 PMCID: PMC4215845 DOI: 10.1371/journal.pone.0108983] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Accepted: 09/03/2014] [Indexed: 11/20/2022] Open
Abstract
Objective Although the plasma B-type natriuretic peptide (BNP) level is a marker of heart failure, it is unclear whether BNP per se plays a pivotal role for pathogenic mechanisms underlying the development of ischemic heart disease (IHD). In this study, we retrospectively examined the plasma BNP levels in stable patients with IHD and compared to stable patients with cardiovascular diseases other than IHD. Methods The study population was 2088 patients (1698 males and 390 females) who were admitted to our hospital due to IHD (n = 1,661) and non-IHD (n = 427) and underwent cardiac catheterization. Measurements of the hemodynamic parameters and blood sampling were performed. Results The plasma BNP levels were significantly lower in the IHD group than in the non-IHD group (p<0.001). The multiple regression analysis examining the logBNP values showed that age, a male gender, low left ventricular ejection fraction, low body mass index, serum creatinine, atrial fibrillation and IHD per se were significant explanatory variables. When the total study population was divided according to gender, the plasma BNP levels were found to be significantly lower in the IHD group than in the non-IHD group among males (p<0.001), but not females (p = NS). Furthermore, a multiple logistic regression analysis of IHD showed the logBNP value to be a significant explanatory variable in males (regression coefficient: −0.669, p<0.001), but not females (p = NS). Conclusions The plasma BNP levels were relatively low in stable patients with IHD compared with those observed in stable patients with non-IHD; this tendency was evident in males. Perhaps, the low reactivity of BNP is causally associated with IHD in males. We hope that this study will serve as a test of future prospective studies.
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Affiliation(s)
- Kosuke Minai
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
- * E-mail:
| | - Takayuki Ogawa
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Makoto Kawai
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Kimiaki Komukai
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Toshikazu Tanaka
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Kazuo Ogawa
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Tomohisa Nagoshi
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Satoshi Arase
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Satoshi Morimoto
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Yasunori Inoue
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroshi Sekiyama
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Akihiro Urabe
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Seiichiro Matsuo
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Kenichi Hongo
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Michihiro Yoshimura
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
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15
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Lanfear DE, Chow S, Padhukasahasram B, Li J, Langholz D, Tang WHW, Williams LK, Sabbah HN. Genetic and nongenetic factors influencing pharmacokinetics of B-type natriuretic peptide. J Card Fail 2014; 20:662-8. [PMID: 24983826 PMCID: PMC4189182 DOI: 10.1016/j.cardfail.2014.06.357] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Revised: 05/30/2014] [Accepted: 06/20/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Natriuretic peptides (NPs) represent a critical pathway in heart failure (HF). However, there is wide individual variability in NP system activity, which could be partly genetic in origin. We explored genetic and nongenetic contributions to B-type natriuretic peptide (BNP) inactivation. METHODS Chronic HF patients (n = 95) received recombinant human BNP (nesiritide) at standard doses, and BNP levels were measured at baseline, after 2 hours of infusion, and 30 minutes after discontinuation. Genomic DNA was genotyped for 91 single-nucleotide polymorphisms (SNP) in 2 candidate genes. We tested the association of patient characteristics and genotype with 5 pharmacokinetics (PK) parameters: elimination rate constant, ΔBNP, BNP clearance, adjusted BNP clearance, and half-life. Linear regression with pleiotropic analysis was used to test genotype associations with PK. RESULTS Participants' mean age was 63 years, 44% were female, and 46% were African American. PK parameters varied widely, some >10-fold. HF type (preserved vs reduced) was associated with PK (P < .01), whereas renal function, demographics, and body mass index and were not. Two SNPs in MME (rs989692, rs6798179) and 2 in NPR3 (rs6880564, rs2062708) also had associations with PK (P < .05). CONCLUSIONS The pharmacokinetics of BNP varies greatly in HF patients, differs by HF type, and possibly by MME or NPR3 genotype. Additional study is warranted.
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Affiliation(s)
- David E Lanfear
- Advanced Heart Failure and Transplant Cardiology, Section, Cardiology Division, Department of Medicine, Henry Ford Hospital, Detroit, Michigan.
| | - Sheryl Chow
- Advanced Heart Failure and Transplant Cardiology, Section, Cardiology Division, Department of Medicine, Henry Ford Hospital, Detroit, Michigan
| | - Badri Padhukasahasram
- Advanced Heart Failure and Transplant Cardiology, Section, Cardiology Division, Department of Medicine, Henry Ford Hospital, Detroit, Michigan
| | - Jia Li
- Advanced Heart Failure and Transplant Cardiology, Section, Cardiology Division, Department of Medicine, Henry Ford Hospital, Detroit, Michigan
| | - David Langholz
- Advanced Heart Failure and Transplant Cardiology, Section, Cardiology Division, Department of Medicine, Henry Ford Hospital, Detroit, Michigan
| | - W H Wilson Tang
- Advanced Heart Failure and Transplant Cardiology, Section, Cardiology Division, Department of Medicine, Henry Ford Hospital, Detroit, Michigan
| | - L Keoki Williams
- Advanced Heart Failure and Transplant Cardiology, Section, Cardiology Division, Department of Medicine, Henry Ford Hospital, Detroit, Michigan
| | - Hani N Sabbah
- Advanced Heart Failure and Transplant Cardiology, Section, Cardiology Division, Department of Medicine, Henry Ford Hospital, Detroit, Michigan
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16
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Madamanchi C, Alhosaini H, Sumida A, Runge MS. Obesity and natriuretic peptides, BNP and NT-proBNP: mechanisms and diagnostic implications for heart failure. Int J Cardiol 2014; 176:611-7. [PMID: 25156856 DOI: 10.1016/j.ijcard.2014.08.007] [Citation(s) in RCA: 210] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 07/04/2014] [Accepted: 08/02/2014] [Indexed: 01/06/2023]
Abstract
Many advances have been made in the diagnosis and management of heart failure (HF) in recent years. Cardiac biomarkers are an essential tool for clinicians: point of care B-type natriuretic peptide (BNP) and its N-terminal counterpart (NT-proBNP) levels help distinguish cardiac from non-cardiac causes of dyspnea and are also useful in the prognosis and monitoring of the efficacy of therapy. One of the major limitations of HF biomarkers is in obese patients where the relationship between BNP and NT-proBNP levels and myocardial stiffness is complex. Recent data suggest an inverse relationship between BNP and NT-proBNP levels and body mass index. Given the ever-increasing prevalence of obesity world-wide, it is important to understand the benefits and limitations of HF biomarkers in this population. This review will explore the biology, physiology, and pathophysiology of these peptides and the cardiac endocrine paradox in HF. We also examine the clinical evidence, mechanisms, and plausible biological explanations for the discord between BNP levels and HF in obese patients.
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Affiliation(s)
| | | | - Arihiro Sumida
- Department of Medicine, University of North Carolina at Chapel Hill, NC, USA
| | - Marschall S Runge
- Department of Medicine, University of North Carolina at Chapel Hill, NC, USA.
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17
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Association of genetic variation with gene expression and protein abundance within the natriuretic peptide pathway. J Cardiovasc Transl Res 2013; 6:826-33. [PMID: 23835779 DOI: 10.1007/s12265-013-9491-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 06/17/2013] [Indexed: 01/09/2023]
Abstract
The natriuretic peptide (NP) system is a critical physiologic pathway in heart failure with wide individual variability in functioning. We investigated the genetic component by testing the association of single nucleotide polymorphisms (SNP) with RNA and protein expression. Samples of DNA, RNA, and tissue from human kidney (n = 103) underwent genotyping, RT-PCR, and protein quantitation (in lysates), for four candidate genes [NP receptor 1 (NPR1), NPR2, and NPR3 and membrane metalloendopeptidase]. The association of genetic variation with expression was tested using linear regression for individual SNPs, and a principal components (PC) method for overall gene variation. Eleven SNPs in NPR2 were significantly associated with protein expression (false discovery rate ≤0.05), but not RNA quantity. RNA and protein quantity correlated poorly with each other. The PC analysis showed only NPR2 as significant. Assessment of the clinical impact of NPR2 genetic variation is needed.
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18
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Choi EY, Bahrami H, Wu CO, Greenland P, Cushman M, Daniels LB, Almeida ALC, Yoneyama K, Opdahl A, Jain A, Criqui MH, Siscovick D, Darwin C, Maisel A, Bluemke DA, Lima JAC. N-terminal pro-B-type natriuretic peptide, left ventricular mass, and incident heart failure: Multi-Ethnic Study of Atherosclerosis. Circ Heart Fail 2012; 5:727-34. [PMID: 23032197 DOI: 10.1161/circheartfailure.112.968701] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP) is associated with clinically overt heart failure (HF). However, whether it provides additive prognostic information for incident HF beyond traditional risk factors and left ventricular (LV) mass index among multi-ethnic asymptomatic individuals has not yet been determined. We studied the associations of plasma NT-proBNP and magnetic resonance imaging defined LV mass index with incident HF in an asymptomatic multi-ethnic population. METHODS AND RESULTS A total of 5597 multi-ethnic participants without clinically apparent cardiovascular disease underwent baseline measurement of NT-proBNP and were followed for 5.5±1.1 years. Among them, 4163 also underwent baseline cardiac magnetic resonance imaging. During follow-up, 111 participants experienced incident HF. Higher NT-proBNP was significantly associated with incident HF, independent of baseline age, sex, ethnicity, systolic blood pressure, diabetes mellitus, smoking, estimated glomerular filtration rate, medications (anti-hypertensive and statin), LV mass index, and interim myocardial infarction (hazard ratio: 1.95 per 1U log NT-proBNP increment, 95% CI 1.54-2.46, P<0.001). This relationship held among different ethnic groups, non-Hispanic whites, African-Americans, and Hispanics. Most importantly, NT-proBNP provided additive prognostic value beyond both traditional risk factors and LV mass index for predicting incident HF (integrated discrimination index=0.046, P<0.001; net reclassification index; 6-year risk probability categorized by <3%, 3-10%, >10% =0.175, P=0.019; category-less net reclassification index=0.561, P<0.001). CONCLUSIONS Plasma NT-proBNP provides incremental prognostic information beyond traditional risk factors and the magnetic resonance imaging-determined LV mass index for incident symptomatic HF in an asymptomatic multi-ethnic population. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00005487.
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19
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McKie PM, Cataliotti A, Lahr BD, Martin FL, Redfield MM, Bailey KR, Rodeheffer RJ, Burnett JC. The prognostic value of N-terminal pro-B-type natriuretic peptide for death and cardiovascular events in healthy normal and stage A/B heart failure subjects. J Am Coll Cardiol 2010; 55:2140-7. [PMID: 20447539 DOI: 10.1016/j.jacc.2010.01.031] [Citation(s) in RCA: 139] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2009] [Revised: 12/04/2009] [Accepted: 01/11/2010] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Our objective was to determine the prognostic value of plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) for death and cardiovascular events among subjects without risk factors for heart failure (HF), which we term healthy normal. BACKGROUND Previous studies report that plasma NT-proBNP has prognostic value for cardiovascular events in the general population even in the absence of HF. It is unclear if NT-proBNP retains predictive value in healthy normal subjects. METHODS We identified a community-based cohort of 2,042 subjects in Olmsted County, Minnesota. Subjects with symptomatic (stage C/D) HF were excluded. The remaining 1,991 subjects underwent echocardiography and NT-proBNP measurement. We further defined healthy normal (n = 703) and stage A/B HF (n = 1,288) subgroups. Healthy normal was defined as the absence of traditional clinical cardiovascular risk factors and echocardiographic structural cardiac abnormalities. Subjects were followed for death, HF, cerebrovascular accident, and myocardial infarction with median follow-up of 9.1, 8.7, 8.8, and 8.9 years, respectively. RESULTS NT-proBNP was not predictive of death or cardiovascular events in the healthy normal subgroup. Similar to previous reports, in stage A/B HF, plasma NT-proBNP values greater than age-/sex-specific 80th percentiles were associated with increased risk of death, HF, cerebrovascular accident, and myocardial infarction (p < 0.001 for all) even after adjustment for clinical risk factors and structural cardiac abnormalities. CONCLUSIONS These findings do not support the use of NT-proBNP as a cardiovascular biomarker in healthy normal subjects and have important implications for NT-proBNP-based strategies for early detection and primary prevention of cardiovascular disease.
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Affiliation(s)
- Paul M McKie
- Cardiorenal Research Laboratory, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA.
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