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Brain natriuretic peptide and P wave duration in dialysis patients

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Abstract

Objectives

P wave duration and dispersion, defined as the difference between the maximum and minimum P duration, are regarded as very important non-invasive ECG markers for assessing atrial arrhythmia risk. Plasma brain natriuretic peptide (BNP) level is an independent predictor of recurrence of atrial fibrillation. We compared the effects of hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) on P wave duration, P dispersion, and BNP in end-stage renal disease (ESRD) patients and examined the relationship between BNP levels, P wave duration, and P dispersion.

Design and methods

Age-matched 22 HD patients (mean age 52.3 ± 14.0 years) and 19 CAPD patients (mean age 46.7 ± 10.9 years) were studied.

Results

BNP levels were greater in HD patients before the HD session (459.0 ± 465.1 pg mL−1) than in CAPD patients (139.0 ± 170.1 pg mL−1). The maximum and minimum P duration, and P dispersion, were similar for both groups (P > 0.05). Whereas BNP levels were negatively related to minimum P duration (r = −0.518, P = 0.019), BNP levels were positively correlated with systolic blood pressure and diastolic blood pressure (r = 0.672, P = 0.001 and r = 0.497, P = 0.022, respectively) in HD patients.

Conclusions

Whereas BNP levels are higher in HD patients when they are at peak-volume status, just before HD, P wave duration and P dispersion were similar for both groups. A negative relationship was detected between BNP levels and minimum P duration in HD patients. Expansion of extra-cellular volume causing myocardial stretching may be the principal cause of increased BNP in HD patients. A functional relationship between BNP and the P wave was not found. Additional studies are needed to evaluate the effect of BNP on the P wave.

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References

  1. Cheung BM, Kumana CR (1998) Natriuretic peptides-relevance in cardiovascular disease. JAMA 280: 1983–1984

    Article  PubMed  CAS  Google Scholar 

  2. Inoue S, Murakami Y, Sano K et al (2000) Atrium as a source of brain natriuretic polypeptide in patients with atrial fibrillation. J Card Fail. 6:92–96

    Article  PubMed  CAS  Google Scholar 

  3. Arima M, Kanoh T, Kawano Y et al (2002) Plasma levels of brain natriuretic peptide increase in patients with idiopathic bilateral atrial dilatation. Cardiology 97:12–17

    Article  PubMed  CAS  Google Scholar 

  4. Nishikimi T, Yoshihara F, Morimoto A et al (1996) Relationship between left ventricular geometry and natriuretic peptide levels in essential hypertension. Hypertension 28:22–30

    PubMed  CAS  Google Scholar 

  5. Stanton E, Hansen M, Wijeysundera HC, Kupchak P, Hall C, Rouleau JL (2005) PRAISE-2 study investigators. A direct comparison of the natriuretic peptides and their relationship to survival in chronic heart failure of a presumed non-ischaemic origin. Eur J Heart Fail 7:557–565

    Article  PubMed  CAS  Google Scholar 

  6. Mabuchi N, Tsutamoto T, Maeda K et al (2000) Plasma cardiac natriuretic peptides as biochemical markers of recurrence of atrial fibrillation in patients with mild congestive heart failure. Jpn Circ J 64:765–771

    Article  PubMed  CAS  Google Scholar 

  7. Lellouche N, Berthier R, Mekontso-Dessap A et al (2005) Usefulness of plasma B-type natriuretic peptide in predicting recurrence of atrial fibrillation one year after external cardioversion. Am J Cardiol 95: 1380–1382

    Article  PubMed  CAS  Google Scholar 

  8. Horie H, Tsutamoto T, Minai K et al (2000) Brain natriuretic peptide predicts chronic atrial fibrillation after ventricular pacing in patients with sick sinus syndrome. Jpn Circ J 64:965–970

    Article  PubMed  CAS  Google Scholar 

  9. Ellinor PT, Low AF, Patton KK, Shea MA, Macrae CA (2005) Discordant atrial natriuretic peptide and brain natriuretic peptide levels in lone atrial fibrillation. J Am Coll Cardiol 45:82–86

    Article  PubMed  CAS  Google Scholar 

  10. Dilaveris PE. Gialafos EJ, Sideris SK et al (1998) Simple electrocardiographic markers to the prediction of paroxysmal idiopathic atrial fibrillation. Am Heart J 135:733–738

    Article  Google Scholar 

  11. Dilaveris PE, Andrikopoulos GK, Metaxas G et al (1999) Effects of ischemia on P wave dispersion and maximum P wave duration during spontaneous anginal episodes. Pacing Clin Electrophysiol 22:1640–1647

    Article  PubMed  CAS  Google Scholar 

  12. Mallamaci F, Zoccali C, Tripepi G et al (2001) Diagnostic potential of cardiac natriuretic peptides in dialysis patients. Kidney Int 59:1559–1566

    Article  PubMed  CAS  Google Scholar 

  13. Zoccali C, Mallamaci F, Benedetto FA et al (2001) Cardiac natriuretic peptides are related to left ventricular mass and function and predict mortality in dialysis patients. J Am Soc Nephrol 12:1508–1515

    PubMed  CAS  Google Scholar 

  14. Nakatani T, Naganuma T, Masuda C et al (2002) Significance of brain natriuretic peptides in patients on continuous ambulatory peritoneal dialysis. Int J Mol Med 10:457–461

    PubMed  CAS  Google Scholar 

  15. Szabo Z, Kakuk G, Fulop T et al (2002) Effects of haemodialysis on maximum P wave duration and P wave␣dispersion. Nephrol Dial Transplant 17: 1634–1638

    Article  PubMed  Google Scholar 

  16. Chen HH, Burnett JC (1999) The natriuretic peptides in heart failure: diagnostic and therapeutic potentials. Proc Assoc Am Physicians 111:406–416

    PubMed  CAS  Google Scholar 

  17. Tonolo G, McMillan M, Polonia J et al (1988) Plasma clearance and effects of alpha-hANP infused in patients with end-stage renal failure. Am J Physiol. 254:895–899

    Google Scholar 

  18. Fagugli RM, Palumbo B, Ricciardi D et al (2003) Association between brain natriuretic peptide and extracellular water in hemodialysis patients. Nephron Clin Pract 95:60–66

    Article  Google Scholar 

  19. Woods RL (2004) Cardioprotective functions of atrial natriuretic peptide and B-type natriuretic peptide: a brief review. Clin Exp Pharmacol Physiol 31:791–794

    Article  PubMed  CAS  Google Scholar 

  20. Hansson M (2002) Natriuretic peptides in relation to the cardiac innervation and conduction system. Microsc Res Tech 58:378–386

    Article  PubMed  CAS  Google Scholar 

  21. Hansson M, Forsgern S (1995) Immunoreactive atrial and brain natriuretic peptides are co-localized in Purkinje fibers but not in the innervation of the bovine heart conduction system. Histochem J 27:222–230

    PubMed  CAS  Google Scholar 

  22. Hansson M, Eriksson A, Forsgren S (1997) Natriuretic peptide immunoreactivity in nerve structures and Purkinje fibers of human, pig and sheep hearts. Histochem J 29:329–336

    Article  PubMed  CAS  Google Scholar 

  23. Toshimori H, Toshimori K, Oura C, Matsuo H (1987) Immunohistochemical study of atrial natriuretic polypeptides in the embryonic, fetal and neonatal rat heart. Cell Tissue Res 248:627–633

    Article  PubMed  CAS  Google Scholar 

  24. Pucci A, Wharton J, Arbustini E et al (1992) Localization of brain and atrial natriuretic peptide in human and porcine heart. Int J Cardiol 34:237–247

    Article  PubMed  CAS  Google Scholar 

  25. Clemo HF, Baumgarten CM, Ellenbogen KA, Stampler BS (1996) Atrial natriuretic peptide and cardiac electrophysiology: autonomic and direct effects. J␣Cardiovasc Electrophysiol 7:149–162

    Article  PubMed  CAS  Google Scholar 

  26. Butler GC, Senn BL, Floras JS (1995) Influence of atrial natriuretic factor on spontaneous baroreflex sensitivity for heart rate in humans. Hypertension 25:1167–1171

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Biochemistry, Turgut Ozal Medical Center of Inonu University Medical Faculty, Malatya, Turkey

    M. Cagatay Taskapan

  2. Department of Internal Medicine, Turgut Ozal Medical Center of Inonu University Medical Faculty, Malatya, Turkey

    Soner Senel & Ozkan Ulutas

  3. Department of Cardiology, Turgut Ozal Medical Center of Inonu University Medical Faculty, Malatya, Turkey

    Yuksel Aksoy & Feridun Kosar

  4. Department of Endocrinology, Turgut Ozal Medical Center of Inonu University Medical Faculty, Malatya, Turkey

    Ibrahim Sahin

  5. Department of Nephrology, Turgut Ozal Medical Center of Inonu University Medical Faculty, Malatya, Turkey

    Hulya Taskapan

Authors
  1. M. Cagatay Taskapan
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  2. Soner Senel
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  3. Ozkan Ulutas
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  4. Yuksel Aksoy
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  5. Ibrahim Sahin
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  6. Feridun Kosar
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  7. Hulya Taskapan
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Correspondence to M. Cagatay Taskapan.

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Taskapan, M.C., Senel, S., Ulutas, O. et al. Brain natriuretic peptide and P wave duration in dialysis patients. Int Urol Nephrol 39, 603–608 (2007). https://doi.org/10.1007/s11255-007-9191-0

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  • DOI: https://doi.org/10.1007/s11255-007-9191-0

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