Plasma levels of brain and atrial natriuretic peptides elevate in proportion to left ventricular end-systolic wall stress in patients with aortic stenosis☆,☆☆,★
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Patients
Thirteen patients (5 men and 8 women; range 52 to 78 years, mean 66 years) with AS were the subjects of this study (Table I) . The diagnosis of AS was made by cardiac catheterization and echocardiography. Three patients were also diagnosed as having mild aortic regurgitation. Tricuspid regurgitation was observed in one patient. Mitral regurgitation was not found in any patients. Preoperative renal function was within normal limits (BUN ≤23 mg/dl, serum creatinine ≤2.0 mg/dl) in 11 patients. In
Plasma levels of BNP and ANP in patients before operation and in unaffected subjects
Table I shows the plasma levels of BNP and ANP in the patients with AS or CAD before operation and in the unaffected subjects. The Log BNP in the unaffected subjects, in the patients with CAD, and in the patients with AS was 1.12 ± 0.09, 1.55 ± 0.11, and 2.24 ± 0.16, respectively (Fig. 1) . These values were significantly different among the three groups ( p < 0.0001),
DISCUSSION
This study demonstrated that the plasma levels of BNP and ANP were elevated in the patients with AS compared with the unaffected subjects. As we previously reported, BNP is synthesized predominantly in the cardiac ventricle, 3, 23 and the increase of the plasma level of BNP is caused by the increase of ventricular production of BNP. 3 This study therefore suggested that, in the patients with AS, the synthesis of BNP can be stimulated either by elevated left ventricular systolic pressure itself
Acknowledgements
We thank Dr. Jun-ichi Soneda, Dr. Toshifumi Takeuchi, Dr. Teiji Oda, Dr. Kazunobu Nishimura, and the staff of the Department of Cardiovascular Surgery, Kyoto University Hospital, for their cooperation in this study. We also thank Mr. Shigeru Kubo in Kyoto Koseikai Hospital and Ms. Yuko Mori for technical assistance.
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Cited by (0)
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From the Departments of Cardiovascular Surgery, Anesthesia, and Medicine and Clinical Science, Kyoto University Graduate School of Medicine.
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Reprint requests: Katsuhiko Matsuda, MD, Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-01 Japan.
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0002-8703/97/$5.00 + 0 4/1/75865