Is Urinary Sodium a Surrogate Marker of Plasma Brain Natriuretic Peptide in ST Elevation Myocardial Infarction?
Abstract
Background. High level of Brain Natriuretic Peptide (BNP) was suspected as a predictor of adverse events in acute ST Elevation Myocardial Infarc-tion (STEMI). Unfortunately, the cost and availability of BNP assay had hampered its use. Natriuresis is one of the hallmark effect of raised BNP and measuring urinary sodium might offer insight to the plasma BNP. This study aims to search for any correlation between measured plasma BNP and urinary sodium in patients presenting with acute STEMI.Methods. In an observational descriptive analytic study, we selectively in-cluded patients presenting with acute STEMI and checked for plasma BNP and urinary sodium. All patients had no symptoms or therapy of heart failure prior to admission, had no prior MI, had no valvular abnormalities, and had normal renal function. Plasma BNP was tested using immunoassay method from Abbot Diagnostics, while urinary sodium with ionic specific electrode method. Specimen for plasma BNP were taken at the admission while urinary sodium in the next morning, taking account of urine volume.
Results. There were 17 patients, 15 were (82.4%) men, with age 55.1+8.2 years old, onset of STEMI 18.6+2.3 hours, and left ventricular ejection fraction (LVEF) 47.6+11.6%. The urinary sodium was 85.1+34.3 mEq/L, and plasma BNP 449.7+48.8 pg/ml. Pearson’s correlation and linear re-gression analysis showed positive correlation between urinary sodium and plasma BNP (r = 0.71). In multivariate analysis, plasma BNP (p<0.01) and LVEF (p<0.05) were the major influencing factors for urinary sodium level.
Conclusion.This study revealed a strong correlation between plasma BNP and urinary sodium in patients presenting with acute STEMI. While mea-surement of urinary sodium cannot replace plasma BNP, it might actually reflect plasma BNP level.
Downloads
Download data is not yet available.
References
Levin ER, Gardner DG, Samson WK. Natriuretic Peptide. N Engl J Med1998;339 (5): 321-327
Bassan R, Potsch A, Maisel A, Tura B, Villacorta H, Nogueira MV, Campos A, Gamarski R, Antonio et al. B-type natriuretic peptide: a novel early blood marker of acute myocardial infarction in patients with chest pain and ST-segment elevation. Eur Heart J2005. 26, 234–240
Morita E, Yasue H, Yoshimura M et al. Increased plasma levels of brain natriuretic peptide in patients with acute myocardial infarction. Circulation 1993;88:82–91.
Omland T. Plasma Brain Natriuretic Peptide as an Indicator of Left Ventricular Systolic Function and Long-term Survival Af-ter Acute Myocardial Infarction Circulation.1996;93:1963-1969.
Maeda K, Tsutamoto T, Wada A et al. Plasma brain natriuretic peptide as a biochemical marker of high left ventricular end-diastolic pressure in patients with symptomatic left ventricular dysfunction. Am Heart J1998;135:825–832.
Richards AM, Nicholls MG, Yandle TG, et al. Plasma N- ter-minal pro-brain natriuretic peptide and adrenomedullin: new neurohormonal predictors of left ventricular function and prog-nosis after myocardial infarction. Circulation. 1998;97:1921–1929.
Omland T, Persson A, Ng L, et al. N-terminal pro-B-type natri-uretic peptide and long-term mortality in acute coronary syn-dromes. Circulation. 2002;106:2913–2918.
de Lemos JA, Morrow DA, Bentley JH et al. The prognostic value of B-type natriuretic peptide in patients with acute coro-nary syndromes. N Engl J Med2001;345:1014–1021.
Davidson NC, Struthers AD. Brain natriuretic peptide. J Hypertens.1994;12:329-336.
Espiner EA. Physiology of natriuretic peptides. J Intern Med. 1994;235:527-541.
Betowski J, Wójcicka G. Regulation of renal tubular sodium transport by cardiac natriuretic peptides: two decades of research. Med Sci Monit, 2002; 8(2): 39-52
La Villa G, Stefani L, Lazzeri C, Zurli C, Guerra CT, Barletta G, Bandinelli R et al. Acute Effects of Physiological Increments of Brain Natriuretic Peptide in Humans. Hypertension. 1995;26:628-633.
Watanabe I. Relationship between the plasma levels of brain natriuretic peptide and left ventricular ejection fraction in as-ymptomatic patients with previous myocardial infarction. Int Heart J2005; 46: 1007-1014
Kamata K, Tochikubo O. Estimation of 24-h urinary so-dium excretion using lean body mass and overnight urine collected by a pipe-sampling method. J Hyper tens. 2002;20(11):2191-7.
Tsai TJ. Comparison between spot urine and overnight urine in the estimation of 24-hour excretion of urine protein, sodium and kallikrein. J Formos Med Assoc. 1991;90(8):755-9.
Lubien E, DeMaria A, Krishnaswamy P, Clopton P, Koon J, Kazanegra R, Gardetto N, Wanner E et al. Utility of B-Natri-uretic Peptide in detecting diastolic dysfunction: comparison with doppler velocity recordings. Circulation. 2002;105:595-601.
Yamaguchi H, Yoshida J, Yamamoto K, Sakata Y, Mano T, Akehi N, Yori M et al. Elevation of plasma brain natriuretic peptide is a hallmark of diastolic heart failure independent of ventricular hypertrophy. J Am Coll Cardiol, 2004; 43:55-60.
Bassan R, Potsch A, Maisel A, Tura B, Villacorta H, Nogueira MV, Campos A, Gamarski R, Antonio et al. B-type natriuretic peptide: a novel early blood marker of acute myocardial infarction in patients with chest pain and ST-segment elevation. Eur Heart J2005. 26, 234–240
Morita E, Yasue H, Yoshimura M et al. Increased plasma levels of brain natriuretic peptide in patients with acute myocardial infarction. Circulation 1993;88:82–91.
Omland T. Plasma Brain Natriuretic Peptide as an Indicator of Left Ventricular Systolic Function and Long-term Survival Af-ter Acute Myocardial Infarction Circulation.1996;93:1963-1969.
Maeda K, Tsutamoto T, Wada A et al. Plasma brain natriuretic peptide as a biochemical marker of high left ventricular end-diastolic pressure in patients with symptomatic left ventricular dysfunction. Am Heart J1998;135:825–832.
Richards AM, Nicholls MG, Yandle TG, et al. Plasma N- ter-minal pro-brain natriuretic peptide and adrenomedullin: new neurohormonal predictors of left ventricular function and prog-nosis after myocardial infarction. Circulation. 1998;97:1921–1929.
Omland T, Persson A, Ng L, et al. N-terminal pro-B-type natri-uretic peptide and long-term mortality in acute coronary syn-dromes. Circulation. 2002;106:2913–2918.
de Lemos JA, Morrow DA, Bentley JH et al. The prognostic value of B-type natriuretic peptide in patients with acute coro-nary syndromes. N Engl J Med2001;345:1014–1021.
Davidson NC, Struthers AD. Brain natriuretic peptide. J Hypertens.1994;12:329-336.
Espiner EA. Physiology of natriuretic peptides. J Intern Med. 1994;235:527-541.
Betowski J, Wójcicka G. Regulation of renal tubular sodium transport by cardiac natriuretic peptides: two decades of research. Med Sci Monit, 2002; 8(2): 39-52
La Villa G, Stefani L, Lazzeri C, Zurli C, Guerra CT, Barletta G, Bandinelli R et al. Acute Effects of Physiological Increments of Brain Natriuretic Peptide in Humans. Hypertension. 1995;26:628-633.
Watanabe I. Relationship between the plasma levels of brain natriuretic peptide and left ventricular ejection fraction in as-ymptomatic patients with previous myocardial infarction. Int Heart J2005; 46: 1007-1014
Kamata K, Tochikubo O. Estimation of 24-h urinary so-dium excretion using lean body mass and overnight urine collected by a pipe-sampling method. J Hyper tens. 2002;20(11):2191-7.
Tsai TJ. Comparison between spot urine and overnight urine in the estimation of 24-hour excretion of urine protein, sodium and kallikrein. J Formos Med Assoc. 1991;90(8):755-9.
Lubien E, DeMaria A, Krishnaswamy P, Clopton P, Koon J, Kazanegra R, Gardetto N, Wanner E et al. Utility of B-Natri-uretic Peptide in detecting diastolic dysfunction: comparison with doppler velocity recordings. Circulation. 2002;105:595-601.
Yamaguchi H, Yoshida J, Yamamoto K, Sakata Y, Mano T, Akehi N, Yori M et al. Elevation of plasma brain natriuretic peptide is a hallmark of diastolic heart failure independent of ventricular hypertrophy. J Am Coll Cardiol, 2004; 43:55-60.
Views & Downloads
Abstract views: 2660
PDF downloads: 1664
PDF downloads: 1664
How to Cite
Martha, J., Hariawan, H., Taofan, S., Hersunarti, N., & Siswanto, B. (1). Is Urinary Sodium a Surrogate Marker of Plasma Brain Natriuretic Peptide in ST Elevation Myocardial Infarction?. Indonesian Journal of Cardiology, 28(1), 19-26. https://doi.org/10.30701/ijc.v28i1.263
Section
Clinical Research
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
