P-544: BNP, ANP and ET-1 for the evaluation of chronic heart failure with left ventricular systolic dysfunction

Abstract

Objective:

Assessment of the importance of plasma BNP, ANP, and ET-1 in a controlled hypertensive population, NYHA class III-IV, with ejection fraction (EF) ≤40%.

Design and Methods:

BNP, ANP and ET- 1 have been investigated as a diagnostic and prognostic tool in chronic heart failure (CHF) with left ventricular (LV) dysfunction. In a controlled hypertensive population of 50 patients with dilated cardiomyopathy in NYHA class III-IV and EF ≤40%, measured by echocardiography biplane disc summation method (Simpson's rule) [mean age(±SD) 67.4±11.1 years; female (F): 12 (24%); male (M): 38 (76%)] and 20 normal controls [mean age 54.5±13.7 years; F: 11 (55%); M: 9 (45%)], plasma BNP (pmol/l) and ANP (pmol/l) were determined with commercial IRMA kits and ET-1 (pg/ml) was measured by radioimmunoassay (RIA). Statistical analysis for BNP and ANP was done by Mann-Whitney-Wilcoxon test and for ET-1 by Student's t test.

Results:

In the patient population, the mean EF was 33±6.4% and in the controls was 61±3.4% (p=0.000). The mean BNP (pmol/l) in the patients was 45.9±48.9 and in the controls was 5.9±8.2 (p= 0.000) and the mean ANP (pmol/l) in the patients was 32.4±20.9 and in the controls was 10.6±8.0(p=0.000). A statistically significant difference was found between patients and healthy controls. The mean ET-1 (pg/ml) in the patients was 4.6±2.6 and in the controls was 2.3±1.4 (p= 0.000). A statistically significant difference was also found between patients and healthy controls.

Conclusions:

BNP, ANP and ET-1 were increased in a population of CHF with a mean EF of 33%, in NYHA class III and IV. A statistically significant difference was found between patients and healthy controls. In CHF patients with moderate to severe LV systolic dysfunction these neuro-hormonal parameters can be useful diagnostic tools.

Non Ischaemic Heart Failure, Natriuretic Peptides, Endothelin-1