Birner, Christoph M. and Ulucan, Coskun and Fredersdorf, Sabine and Rihm, Munhie and Loewel, Hannelore and Stritzke, Jan and Schunkert, Heribert and Hengstenberg, Christian and Holmer, Stephan and Riegger, Guenter and Luchner, Andreas (2007) Head-to-head comparison of BNP and IL-6 as markers of clinical and experimental heart failure: Superiority of BNP. CYTOKINE, 40 (2). pp. 89-97. ISSN 1043-4666,
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Activation of BNP and IL-6 are hallmarks of left ventricular (LV) dysfunction and congestive heart failure (CHF). To assess the relative activation of BNP and IL-6 in clinical and experimental heart failure, we performed a human study in which plasma N-terminal proBNP (NT-proBNP) and IL-6 were measured in a large group of patients in the chronic phase after myocardial infarction (MI) and an animal study in which LV gene expression of BNP and IL-6 was assessed in rapid ventricular pacing-induced heart failure. In the human study, NT-proBNP and IL-6 were measured by non-extracted, enzyme-linked immunoassay in 845 subjects (n=468 outpatients after MI, MONICA MI register Augsburg; and 377 siblings without MI, control). NT-proBNP (295+/-23 pg/mL vs. CTRL 84+/-8, P<0.05) and IL-6 (2.7+/-0.1 pg/mL vs. CTRL 2.1+/-0.1, P<0.05) were both elevated in subjects with MI. These increases were particularly pronounced in the presence of concomitant CHF (both P<0.01 vs. CTRL) and LV dysfunction (EF<45%, both P<0.05 vs. CTRL). However, NT-proBNP was significantly correlated with several cardiac structural and functional parameters (EF, LVMI, history of MI, CHF symptoms; all P<0.05) upon regression analysis whereas IL-6 was only correlated with history of MI (P<0.001). Accordingly, MI subjects with symptomatic LV dysfunction were detected by NT-proBNP with a greater sensitivity, specificity, and ROC-area (85%, 88%, and 0.87, respectively) as compared to IL-6 (69%, 53%, and 0.67, respectively). In the animal study, IL-6 and BNP expression were both significantly elevated in CHF (both P<0.05) but with a much greater absolute activation of BNP. In addition, BNP mRNA expression displayed a stronger inverse correlation with LV function (r=-0.74; P<0.001) than IL-6 (r=-0.53; P=0.001) and was a markedly more sensitive and specific molecular marker of LV dysfunction (sensitivity 91%, specificity 100%, ROC-area 0.94) than IL-6 (sensitivity 74%, specificity 83%, ROC-area 0.87). Our animal study provides evidence that IL-6 expression is activated in heart failure but to a significantly lesser degree than that of BNP. Both the stronger expression of BNP and the better correlation with LV function provide the molecular basis for a diagnostic superiority of NT-proBNP in clinical LV dysfunction and heart failure. (C) 2007 Elsevier Ltd. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | LEFT-VENTRICULAR DYSFUNCTION; BRAIN NATRIURETIC PEPTIDE; MYOCARDIAL-INFARCTION; CYTOKINE EXPRESSION; NT-PROBNP; SYSTOLIC DYSFUNCTION; EMERGENCY DIAGNOSIS; IN-VITRO; INTERLEUKIN-6; HYPERTROPHY; interleukin-6; cytokmes; natriuretic peptides; experimental heart failure |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 27 Nov 2020 07:45 |
| Last Modified: | 27 Nov 2020 07:45 |
| URI: | https://pred.uni-regensburg.de/id/eprint/31957 |
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