Cardiac hormone level indicates increased risk of death, progression of heart failure, researchers report

October 03, 2001

DALLAS - Oct. 4, 2001 - Researchers at UT Southwestern Medical Center at Dallas have found that elevated levels of a cardiac hormone is predictive of an increased risk of death or heart failure in patients with complications of coronary artery disease.

The findings, which are published in today's issue of The New England Journal of Medicine, provide physicians with a new method of assessing adverse outcomes in patients with acute coronary syndromes, said Dr. James de Lemos, lead author of the study and assistant professor of internal medicine at UT Southwestern.

"We've identified a test that is associated with prognosis and seems to be very important for risk stratification. A single measurement of this hormone gives important information about how likely a patient is to die or develop heart failure," he said. De Lemos, who now works in the Donald W. Reynolds Cardiovascular Clinical Research Center at UT Southwestern, collaborated on the research with Dr. Eugene Braunwald, senior author of the paper, at Brigham and Women's Hospital in Boston.

Researchers also found that the level of the hormone, termed brain natriuretic peptide, or BNP, was better at predicting adverse outcomes compared to traditional ways of prognosticating after a heart attack, de Lemos said.

Of the 2,525 patients who participated in the study, approximately half were enrolled after the onset of a heart attack and half after an episode of unstable angina, or chest pains. The researchers obtained a single measurement of BNP from the study participants shortly after admission to the hospital for acute coronary syndromes. These participants were originally part of the multicenter Orbofiban in Patients with Unstable Coronary Syndromes-Thrombolysis in Myocardial Infarction 16 study.

After a 30-day analysis, the researchers found that levels of BNP were higher among patients who died, and patients with a higher BNP were more likely to have a new or recurrent heart attack or develop heart failure or progression of heart failure. Similar findings were reported after a 10-month analysis.

"Even in the patients who had no detectable heart damage from their episode of chest pain, elevated BNP levels identified them as being at high risk of dying or developing heart failure, " de Lemos said.

In contrast, patients with lower levels of BNP were less likely to die or develop heart failure.

BNP is a neurohormone synthesized in the muscular wall of the left ventricle of the heart. It is released into the circulation in response to ventricular dilation and pressure overload.

"We know that this is a hormone that normally has very beneficial effects in the body," de Lemos said. "It promotes excretion of salt by the kidneys, and it dilates blood vessels. It is referred to as a counter-regulatory hormone. It is not well understood why BNP is higher in patients who later go on to die or develop heart failure, but it is possible that the body becomes desensitized to its effects."

Further research is needed to determine medical therapies that might benefit individuals with high BNP levels, de Lemos said.

UT Southwestern physicians will begin using the BNP assay in November.

"The first use of the assay is likely to be in the emergency department, where BNP also appears to help doctors determine which patients with shortness of breath have congestive heart failure as opposed to other causes of shortness of breath, such as lung disease."
-end-
Other study investigators included researchers from Nottingham Clinical Research Group in Nottingham, England, and the Research Institute for Internal Medicine, National Hospital, University of Oslo in Norway.

The study was supported by grants from Searle and Biosite Inc.

UT Southwestern Medical Center

Related Heart Failure Articles from Brightsurf:

Top Science Tip Sheet on heart failure, heart muscle cells, heart attack and atrial fibrillation results
Newly discovered pathway may have potential for treating heart failure - New research model helps predict heart muscle cells' impact on heart function after injury - New mass spectrometry approach generates libraries of glycans in human heart tissue - Understanding heart damage after heart attack and treatment may provide clues for prevention - Understanding atrial fibrillation's effects on heart cells may help find treatments - New research may lead to therapy for heart failure caused by ICI cancer medication

Machining the heart: New predictor for helping to beat chronic heart failure
Researchers from Kanazawa University have used machine learning to predict which classes of chronic heart failure patients are most likely to experience heart failure death, and which are most likely to develop an arrhythmic death or sudden cardiac death.

Heart attacks, heart failure, stroke: COVID-19's dangerous cardiovascular complications
A new guide from emergency medicine doctors details the potentially deadly cardiovascular complications COVID-19 can cause.

Autoimmunity-associated heart dilation tied to heart-failure risk in type 1 diabetes
In people with type 1 diabetes without known cardiovascular disease, the presence of autoantibodies against heart muscle proteins was associated with cardiac magnetic resonance (CMR) imaging evidence of increased volume of the left ventricle (the heart's main pumping chamber), increased muscle mass, and reduced pumping function (ejection fraction), features that are associated with higher risk of failure in the general population

Transcendental Meditation prevents abnormal enlargement of the heart, reduces chronic heart failure
A randomized controlled study recently published in the Hypertension issue of Ethnicity & Disease found the Transcendental Meditation (TM) technique helps prevent abnormal enlargement of the heart compared to health education (HE) controls.

Beta blocker use identified as hospitalization risk factor in 'stiff heart' heart failure
A new study links the use of beta-blockers to heart failure hospitalizations among those with the common 'stiff heart' heart failure subtype.

Type 2 diabetes may affect heart structure and increase complications and death among heart failure patients of Asian ethnicity
The combination of heart failure and Type 2 diabetes can lead to structural changes in the heart, poorer quality of life and increased risk of death, according to a multi-country study in Asia.

Preventive drug therapy may increase right-sided heart failure risk in patients who receive heart devices
Patients treated preemptively with drugs to reduce the risk of right-sided heart failure after heart device implantation may experience the opposite effect and develop heart failure and post-operative bleeding more often than patients not receiving the drugs.

How the enzyme lipoxygenase drives heart failure after heart attacks
Heart failure after a heart attack is a global epidemic leading to heart failure pathology.

Novel heart pump shows superior outcomes in advanced heart failure
Severely ill patients with advanced heart failure who received a novel heart pump -- the HeartMate 3 left ventricular assist device (LVAD) -- suffered significantly fewer strokes, pump-related blood clots and bleeding episodes after two years, compared with similar patients who received an older, more established pump, according to research presented at the American College of Cardiology's 68th Annual Scientific Session.

Read More: Heart Failure News and Heart Failure Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.