Plasma levels of natriuretic peptide and echocardiographic parameters in patients with Duchenne's progressive muscular dystrophy

Pediatr Cardiol. 2002 Mar-Apr;23(2):160-6. doi: 10.1007/s00246-001-0040-0. Epub 2002 Feb 19.

Abstract

We investigated the relationship between plasma atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) levels and systolic and diastolic cardiac function, determined by echocardiography, in 63 patients with Duchenne's progressive muscular dystrophy (DMD) (age range 8-21 years). The relationship between shortening fraction of the left ventricle and ANP and BNP levels was curvilinear rather than linear: When the shortening fraction was >15%, increases in ANP and BNP levels were minimal. However, if the shortening fraction was <15%, both natriuretic peptide levels increased dramatically. Stepwise regression analysis revealed that only the deceleration time of the early diastolic filling wave predicted plasma BNP concentration among various diastolic echocardiographic parameters determined by mitral flow. Three patients died of cardiac dysfunction during a 2-year follow-up period. These patients had a severely decreased deceleration time (<65% of normal) in association with increases in both natriuretic peptide levels. In conclusion, plasma ANP and BNP levels are not sensitive markers for the early detection of cardiac systolic dysfunction in patients with DMD. However, in patients with systolic dysfunction, an increase in the concentrations of these peptides, associated with a decrease in the deceleration time of early diastolic filling, suggests poor prognosis.

MeSH terms

  • Adolescent
  • Adult
  • Atrial Natriuretic Factor / blood*
  • Biomarkers
  • Child
  • Diastole
  • Humans
  • Male
  • Muscular Dystrophy, Duchenne / blood*
  • Muscular Dystrophy, Duchenne / complications
  • Muscular Dystrophy, Duchenne / diagnostic imaging*
  • Natriuretic Peptide, Brain / blood*
  • Sensitivity and Specificity
  • Systole
  • Ultrasonography
  • Ventricular Dysfunction, Left / blood*
  • Ventricular Dysfunction, Left / etiology

Substances

  • Biomarkers
  • Natriuretic Peptide, Brain
  • Atrial Natriuretic Factor