Pro-B-Type Natriuretic Peptide1-108 Circulates in the General Community Plasma Determinants and Detection of Left Ventricular Dysfunction
Pro-B-Type Natriuretic Peptide1-108 Circulates in the General Community Plasma Determinants and Detection of Left Ventricular Dysfunction
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DOI：
10.1016/j.jacc.2011.01.005
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发表时间：
2011-03-22
影响因子：
24
通讯作者：
Burnett, John C., Jr.
中科院分区：
文献类型：
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作者：
Macheret, Fima;Boerrigter, Guido;Burnett, John C., Jr.
目的探讨脑钠肽前体（pro-B-type natriuretic peptide，BNP）在脑梗死患者中的作用（proBNP（1-108））并评估其检测左心室（LV）功能障碍的能力。背景心脏内分泌功能的当前概念是，响应于心脏应激，心脏在其分子前体proBNP（1-108）的心内裂解后分泌B型利钠肽（BNP 1 -32）和氨基末端pro-B型利钠肽（NT-proBNP（1-76））。我们假设proBNP（1-108）在正常人中循环，并且它是LV dysfunction.Methods的有用生物标志物，我们的基于人群的研究包括来自明尼苏达州奥姆斯特德县的1，939名成年人（年龄>= 45岁）的队列，其中672名参与者被定义为健康。受试者接受了深入的临床表征、详细的超声心动图和proBNP测量（1-108）。结果ProBNP（1 - 108）在正常人中受性别、年龄、心率和体重指数的强烈影响。中位浓度为20 ng/l，平均proBNP（1-108）与NT-proBNP（1-76）比值为0.366，随心力衰竭分期降低。ProBNP（1-108）是一种敏感的（78.8%）和特异性（86.1%）检测LV收缩功能障碍的生物标志物，与BNP 1 -32相当，但低于NT-proBNP（1-76），结论ProBNP（1-108）是一种高表达的蛋白质。在一般人群中的大多数健康人中循环，并且是用于检测收缩功能障碍的敏感且特异的生物标志物。proBNP（1-108）与NT-proBNP（1-76）的比值可能有助于了解心力衰竭进展期间proBNP（1-108）加工的变化。因此，proBNP（1-108）的这种高度特异性测定为BNP系统的生物学提供了重要的新见解。（J Am科尔心脏病学杂志2011;57：1386-95）（C）美国心脏病学会基金会2011年
Objectives The purpose of this study was to investigate circulating pro-B-type natriuretic peptide (proBNP(1-108)) in the general community and evaluate its ability to detect left ventricular (LV) dysfunction.Background The current concept for cardiac endocrine function is that, in response to cardiac stress, the heart secretes B-type natriuretic peptide (BNP1-32) and amino-terminal pro-B-type natriuretic peptide (NT-proBNP(1-76)) after intracardiac cleavage of their molecular precursor, proBNP(1-108). We hypothesized that proBNP(1-108) circulates in normal human subjects and that it is a useful biomarker for LV dysfunction.Methods Our population-based study included a cohort of 1,939 adults (age >= 45 years) from Olmsted County, Minnesota, with 672 participants defined as healthy. Subjects underwent in-depth clinical characterization, detailed echocardiography, and measurement of proBNP(1-108). Independent factors associated with proBNP(1-108) and test characteristics for the detection of LV dysfunction were determined.Results ProBNP(1-108) in normal humans was strongly influenced by sex, age, heart rate, and body mass index. The median concentration was 20 ng/l with a mean proBNP(1-108) to NT-proBNP(1-76) ratio of 0.366, which decreased with heart failure stage. ProBNP(1-108) was a sensitive (78.8%) and specific (86.1%) biomarker for detecting LV systolic dysfunction, which was comparable to BNP1-32, but less than NT-proBNP(1-76), in several subsets of the population.Conclusions ProBNP(1-108) circulates in the majority of healthy humans in the general population and is a sensitive and specific biomarker for the detection of systolic dysfunction. The proBNP(1-108) to NT-proBNP(1-76) ratio may provide insights into altered proBNP(1-108) processing during heart failure progression. Thus, this highly specific assay for proBNP(1-108) provides important new insights into the biology of the BNP system. (J Am Coll Cardiol 2011;57:1386-95) (C) 2011 by the American College of Cardiology Foundation