Clinical research progress on brain natriuretic peptide and amino-terminal pro-brain natriuretic peptide_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHU Yihao , WANG Fei ,  ZHU Tao

Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;

Corresponding author：

ZHU Tao, Email: xwtao_zhu@sina.com

Keywords：

Brain natriuretic peptide; amino-terminal pro-brain natriuretic peptide; heart failure; resarch progress; review

DOI：

10.7507/1007-4848.202012084

Video：

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Abstract Full text Figures/Tables Video References Cited by

Brain natriuretic peptide (BNP) and amino-terminal pro-brain natriuretic peptide (NT-proBNP) were the main members of the natriuretic peptide family. BNP has the effects of diuretic sodium, reducing sympathetic nervous system activity, dilating blood vessels, and improving the pathological remodeling of heart. Plasma BNP/NT-proBNP levels have been widely used in the diagnosis, severity assessment, prognosis prediction and treatment guidance of heart failure. In recent years, BNP/NT-proBNP has become a research hotspot in the diagnosis and and prognosis judgment of atrial fibrillation, recurrence of atrial fibrillation after radiofrequency ablation and cardioversion and congenital heart disease in infants and children, prediction of postoperative complications, and drug development. This article reviews the latest advances in clinical application and research progress on BNP/NT-proBNP.

Citation： ZHU Yihao, WANG Fei, ZHU Tao. Clinical research progress on brain natriuretic peptide and amino-terminal pro-brain natriuretic peptide. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2022, 29(12): 1665-1670. doi: 10.7507/1007-4848.202012084 Copy

1.	Sabatine MS, Morrow DA, de Lemos JA, et al. Acute changes in circulating natriuretic peptide levels in relation to myocardial ischemia. J Am Coll Cardiol, 2004, 44(10): 1988-1995.
2.	Phelan D, Watson C, Martos R, et al. Modest elevation in BNP in asymptomatic hypertensive patients reflects sub-clinical cardiac remodeling, inflammation and extracellular matrix changes. PLoS One, 2012, 7(11): e49259.
3.	Okamoto R, Ali Y, Hashizume R, et al. BNP as a major player in the heart-kidney connection. Int J Mol Sci, 2019, 20(14): 3581.
4.	Caprnda M, Zulli A, Shiwani HA, et al. The therapeutic effect of B-type natriuretic peptides in acute decompensated heart failure. Clin Exp Pharmacol Physiol, 2020, 47(7): 1120-1133.
5.	Rodeheffer RJ. Measuring plasma B-type natriuretic peptide in heart failure: Good to go in 2004? J Am Coll Cardiol, 2004, 44(4): 740-749.
6.	Nattel S. Natriuretic peptide receptors and atrial-selective fibrosis: Potential role in atrial fibrillation. Cardiovasc Res, 2019, 115(2): 258-260.
7.	George I, Xydas S, Klotz S, et al. Long-term effects of B-type natriuretic peptide infusion after acute myocardial infarction in a rat model. J Cardiovasc Pharmacol, 2010, 55(1): 14-20.
8.	Otani K, Tokudome T, Kamiya CA, et al. Deficiency of cardiac natriuretic peptide signaling promotes peripartum cardiomyopathy-like remodeling in the mouse heart. Circulation, 2020, 141(7): 571-588.
9.	Madiraju P, Hossain E, Anand-Srivastava MB. Natriuretic peptide receptor-C activation attenuates angiotensin Ⅱ-induced enhanced oxidative stress and hyperproliferation of aortic vascular smooth muscle cells. Mol Cell Biochem, 2018, 448(1-2): 77-89.
10.	Abbas SS, Mahmoud HM, Schaalan MF, et al. Involvement of brain natriuretic peptide signaling pathway in the cardioprotective action of sitagliptin. Pharmacol Rep, 2018, 70(4): 720-729.
11.	Ghashghaei R, Arbit B, Maisel AS. Current and novel biomarkers in heart failure: Bench to bedside. Curr Opin Cardiol, 2016, 31(2): 191-195.
12.	Kenny AJ, Bourne A, Ingram J. Hydrolysis of human and pig brain natriuretic peptides, urodilatin, C-type natriuretic peptide and some C-receptor ligands by endopeptidase-24. 11. Biochem J, 1993, 291(Pt 1): 83-88.
13.	Semenov AG, Katrukha AG. Different susceptibility of B-type natriuretic peptide (BNP) and BNP precursor (proBNP) to cleavage by neprilysin: The N-terminal part does matter. Clin Chem, 2016, 62(4): 617-622.
14.	Dhingra R, Vasan RS. Biomarkers in cardiovascular disease: Statistical assessment and section on key novel heart failure biomarkers. Trends Cardiovasc Med, 2017, 27(2): 123-133.
15.	Maisel A. B-type natriuretic peptide measurements in diagnosing congestive heart failure in the dyspneic emergency department patient. Rev Cardiovasc Med, 2002, 3 Suppl 4: S10-S17.
16.	中华医学会心血管病学分会心力衰竭学组, 中国医师协会心力衰竭专业委员会中华心血管病杂志编辑委员会. 中国心力衰竭诊断和治疗指南2018. 中华心血管病杂志, 2018, 46(10): 760.
17.	Hong KL, Glover BM. The impact of lifestyle intervention on atrial fibrillation. Curr Opin Cardiol, 2018, 33(1): 14-19.
18.	Miake J, Kato M, Ogura K, et al. Pre-ablation levels of brain natriuretic peptide are independently associated with the recurrence of atrial fibrillation after radiofrequency catheter ablation in patients with nonvalvular atrial fibrillation. Heart Vessels, 2019, 34(3): 517-526.
19.	Raman K, Aeschbacher S, Bossard M, et al. Whole blood gene expression differentiates between atrial fibrillation and sinus rhythm after cardioversion. PLoS One, 2016, 11(6): e0157550.
20.	Sepehri Shamloo A, Bollmann A, Dagres N, et al. Natriuretic peptides: Biomarkers for atrial fibrillation management. Clin Res Cardiol, 2020, 109(8): 957-966.
21.	Pedersen KB, Madsen C, Sandgaard NCF, et al. Predictive markers of atrial fibrillation in patients with transient ischemic attack. J Stroke Cerebrovasc Dis, 2020, 29(4): 104643.
22.	Zhao J, Zhang Y, Yuan F, et al. Diagnostic value of N-terminal pro B-type natriuretic peptide for nonvalvular atrial fibrillation in acute ischemic stroke patients: A retrospective multicenter case-control study. J Neurol Sci, 2020, 414: 116822.
23.	Fu S, Ping P, Zhu Q, et al. Brain natriuretic peptide and its biochemical, analytical, and clinical issues in heart failure: A narrative review. Front Physiol, 2018, 9: 692.
24.	Al-Ibrahimi AS, Al-Gazally ME, Alshok MM. Biochemical analysis of the natriuretic peptides BNP and NT-proBNP in patients with cardiovascular disease. Intern Chem Tech Res, 2016, 9(12): 508-519.
25.	El Ashmawy HM, Sadaka MA, Youssef GM, et al. N-terminal pro brain natriuretic peptide in assessment of severity of coronary artery disease in patients with non ST elevation acute coronary syndrome. J Clin Diagn Res, 2020, 14(7): OC30-OC34.
26.	Lin F, Zheng L, Cui Y, et al. Prognostic value of perioperative NT-proBNP after corrective surgery for pediatric congenital heart defects. BMC Pediatr, 2019, 19(1): 497.
27.	Saberinia A, Vafaei A, Kashani P. A narrative review on the management of acute heart failure in emergency medicine department. Eur J Transl Myol, 2020, 30(1): 8612.
28.	Welsh P, Kou L, Yu C, et al. Prognostic importance of emerging cardiac, inflammatory, and renal biomarkers in chronic heart failure patients with reduced ejection fraction and anaemia: RED-HF study. Eur J Heart Fail, 2018, 20(2): 268-277.
29.	Zhang ZL, Li R, Yang FY, et al. Natriuretic peptide family as diagnostic/prognostic biomarker and treatment modality in management of adult and geriatric patients with heart failure: Remaining issues and challenges. J Geriatr Cardiol, 2018, 15(8): 540-546.
30.	Sinner MF, Stepas KA, Moser CB, et al. B-type natriuretic peptide and C-reactive protein in the prediction of atrial fibrillation risk: The CHARGE-AF Consortium of community-based cohort studies. Europace, 2014, 16(10): 1426-1433.
31.	Gao H, Zhang N, Lu F, et al. Circulating histones for predicting prognosis after cardiac surgery: A prospective study. Interact Cardiovasc Thorac Surg, 2016, 23(5): 681-687.
32.	Brandstrup B, Beier-Holgersen R, Iversen LH, et al. The influence of perioperative fluid therapy on N-terminal-pro-brain natriuretic peptide and the association with heart and lung complications in patients undergoing colorectal surgery: Secondary results of a clinical randomized assessor-blinded multicenter trial. Ann Surg, 2020, 272(6): 941-949.
33.	Stokes NR, Dietz BW, Liang JJ. Cardiopulmonary laboratory biomarkers in the evaluation of acute dyspnea. Open Access Emerg Med, 2016, 8: 35-45.
34.	Khan A, Johnson DK, Carlson S, et al. NT-pro BNP predicts myocardial injury post-vascular surgery and is reduced with CoQ 10: A randomized double-blind trial. Ann Vasc Surg, 2020, 64: 292-302.
35.	Kawagoe C, Sato Y, Toida T, et al. N-terminal-pro-B-type-natriuretic peptide associated with 2-year mortality from both cardiovascular and non-cardiovascular origins in prevalent chronic hemodialysis patients. Ren Fail, 2018, 40(1): 127-134.
36.	Wei XB, Liu YH, He PC, et al. Prognostic value of N-terminal prohormone brain natriuretic peptide for in-hospital and long-term outcomes in patients with infective endocarditis. Eur J Prev Cardiol, 2017, 24(7): 676-684.
37.	Stienen S, Salah K, Moons AH, et al. NT-proBNP (N-Terminal pro-B-type natriuretic peptide)-guided therapy in acute decompensated heart failure: PRIMA Ⅱ randomized controlled trial (Can NT-ProBNP-guided therapy during hospital admission for acute decompensated heart failure reduce mortality and readmissions?). Circulation, 2018, 137(16): 1671-1683.
38.	Felker GM, Anstrom KJ, Adams KF, et al. Effect of natriuretic peptide-guided therapy on hospitalization or cardiovascular mortality in high-risk patients with heart failure and reduced ejection fraction: A randomized clinical trial. JAMA, 2017, 318(8): 713-720.
39.	McLellan J, Bankhead CR, Oke JL, et al. Natriuretic peptide-guided treatment for heart failure: A systematic review and meta-analysis. BMJ Evid Based Med, 2020, 25(1): 33-37.
40.	Dandamudi S, Chen HH. The ASCEND-HF trial: An acute study of clinical effectiveness of nesiritide and decompensated heart failure. Expert Rev Cardiovasc Ther, 2012, 10(5): 557-563.
41.	Gong B, Wu Z, Li Z. Efficacy and safety of nesiritide in patients with decompensated heart failure: A meta-analysis of randomised trials. BMJ Open, 2016, 6(1): e008545.
42.	Strain WD. The use of recombinant human B-type natriuretic peptide (nesiritide) in the management of acute decompensated heart failure. Int J Clin Pract, 2004, 58(11): 1081-1087.
43.	Lee CY, Huntley BK, McCormick DJ, et al. Cenderitide: Structural requirements for the creation of a novel dual particulate guanylyl cyclase receptor agonist with renal-enhancing in vivo and ex vivo actions. Eur Heart J Cardiovasc Pharmacother, 2016, 2(2): 98-105.
44.	Kawakami R, Lee CYW, Scott C, et al. A human study to evaluate safety, tolerability, and cyclic GMP activating properties of cenderitide in subjects with stable chronic heart failure. Clin Pharmacol Ther, 2018, 104(3): 546-552.
45.	McMurray JJ, Packer M, Desai AS, et al. Baseline characteristics and treatment of patients in prospective comparison of ARNI with ACEI to determine impact on global mortality and morbidity in heart failure trial (PARADIGM-HF). Eur J Heart Fail, 2014, 16(7): 817-825.
46.	Solomon SD, McMurray JJV, Anand IS, et al. Angiotensin-neprilysin inhibition in heart failure with preserved ejection fraction. N Engl J Med, 2019, 381(17): 1609-1620.

1. Sabatine MS, Morrow DA, de Lemos JA, et al. Acute changes in circulating natriuretic peptide levels in relation to myocardial ischemia. J Am Coll Cardiol, 2004, 44(10): 1988-1995.
2. Phelan D, Watson C, Martos R, et al. Modest elevation in BNP in asymptomatic hypertensive patients reflects sub-clinical cardiac remodeling, inflammation and extracellular matrix changes. PLoS One, 2012, 7(11): e49259.
3. Okamoto R, Ali Y, Hashizume R, et al. BNP as a major player in the heart-kidney connection. Int J Mol Sci, 2019, 20(14): 3581.
4. Caprnda M, Zulli A, Shiwani HA, et al. The therapeutic effect of B-type natriuretic peptides in acute decompensated heart failure. Clin Exp Pharmacol Physiol, 2020, 47(7): 1120-1133.
5. Rodeheffer RJ. Measuring plasma B-type natriuretic peptide in heart failure: Good to go in 2004? J Am Coll Cardiol, 2004, 44(4): 740-749.
6. Nattel S. Natriuretic peptide receptors and atrial-selective fibrosis: Potential role in atrial fibrillation. Cardiovasc Res, 2019, 115(2): 258-260.
7. George I, Xydas S, Klotz S, et al. Long-term effects of B-type natriuretic peptide infusion after acute myocardial infarction in a rat model. J Cardiovasc Pharmacol, 2010, 55(1): 14-20.
8. Otani K, Tokudome T, Kamiya CA, et al. Deficiency of cardiac natriuretic peptide signaling promotes peripartum cardiomyopathy-like remodeling in the mouse heart. Circulation, 2020, 141(7): 571-588.
9. Madiraju P, Hossain E, Anand-Srivastava MB. Natriuretic peptide receptor-C activation attenuates angiotensin Ⅱ-induced enhanced oxidative stress and hyperproliferation of aortic vascular smooth muscle cells. Mol Cell Biochem, 2018, 448(1-2): 77-89.
10. Abbas SS, Mahmoud HM, Schaalan MF, et al. Involvement of brain natriuretic peptide signaling pathway in the cardioprotective action of sitagliptin. Pharmacol Rep, 2018, 70(4): 720-729.
11. Ghashghaei R, Arbit B, Maisel AS. Current and novel biomarkers in heart failure: Bench to bedside. Curr Opin Cardiol, 2016, 31(2): 191-195.
12. Kenny AJ, Bourne A, Ingram J. Hydrolysis of human and pig brain natriuretic peptides, urodilatin, C-type natriuretic peptide and some C-receptor ligands by endopeptidase-24. 11. Biochem J, 1993, 291(Pt 1): 83-88.
13. Semenov AG, Katrukha AG. Different susceptibility of B-type natriuretic peptide (BNP) and BNP precursor (proBNP) to cleavage by neprilysin: The N-terminal part does matter. Clin Chem, 2016, 62(4): 617-622.
14. Dhingra R, Vasan RS. Biomarkers in cardiovascular disease: Statistical assessment and section on key novel heart failure biomarkers. Trends Cardiovasc Med, 2017, 27(2): 123-133.
15. Maisel A. B-type natriuretic peptide measurements in diagnosing congestive heart failure in the dyspneic emergency department patient. Rev Cardiovasc Med, 2002, 3 Suppl 4: S10-S17.
16. 中华医学会心血管病学分会心力衰竭学组, 中国医师协会心力衰竭专业委员会中华心血管病杂志编辑委员会. 中国心力衰竭诊断和治疗指南2018. 中华心血管病杂志, 2018, 46(10): 760.
17. Hong KL, Glover BM. The impact of lifestyle intervention on atrial fibrillation. Curr Opin Cardiol, 2018, 33(1): 14-19.
18. Miake J, Kato M, Ogura K, et al. Pre-ablation levels of brain natriuretic peptide are independently associated with the recurrence of atrial fibrillation after radiofrequency catheter ablation in patients with nonvalvular atrial fibrillation. Heart Vessels, 2019, 34(3): 517-526.
19. Raman K, Aeschbacher S, Bossard M, et al. Whole blood gene expression differentiates between atrial fibrillation and sinus rhythm after cardioversion. PLoS One, 2016, 11(6): e0157550.
20. Sepehri Shamloo A, Bollmann A, Dagres N, et al. Natriuretic peptides: Biomarkers for atrial fibrillation management. Clin Res Cardiol, 2020, 109(8): 957-966.
21. Pedersen KB, Madsen C, Sandgaard NCF, et al. Predictive markers of atrial fibrillation in patients with transient ischemic attack. J Stroke Cerebrovasc Dis, 2020, 29(4): 104643.
22. Zhao J, Zhang Y, Yuan F, et al. Diagnostic value of N-terminal pro B-type natriuretic peptide for nonvalvular atrial fibrillation in acute ischemic stroke patients: A retrospective multicenter case-control study. J Neurol Sci, 2020, 414: 116822.
23. Fu S, Ping P, Zhu Q, et al. Brain natriuretic peptide and its biochemical, analytical, and clinical issues in heart failure: A narrative review. Front Physiol, 2018, 9: 692.
24. Al-Ibrahimi AS, Al-Gazally ME, Alshok MM. Biochemical analysis of the natriuretic peptides BNP and NT-proBNP in patients with cardiovascular disease. Intern Chem Tech Res, 2016, 9(12): 508-519.
25. El Ashmawy HM, Sadaka MA, Youssef GM, et al. N-terminal pro brain natriuretic peptide in assessment of severity of coronary artery disease in patients with non ST elevation acute coronary syndrome. J Clin Diagn Res, 2020, 14(7): OC30-OC34.
26. Lin F, Zheng L, Cui Y, et al. Prognostic value of perioperative NT-proBNP after corrective surgery for pediatric congenital heart defects. BMC Pediatr, 2019, 19(1): 497.
27. Saberinia A, Vafaei A, Kashani P. A narrative review on the management of acute heart failure in emergency medicine department. Eur J Transl Myol, 2020, 30(1): 8612.
28. Welsh P, Kou L, Yu C, et al. Prognostic importance of emerging cardiac, inflammatory, and renal biomarkers in chronic heart failure patients with reduced ejection fraction and anaemia: RED-HF study. Eur J Heart Fail, 2018, 20(2): 268-277.
29. Zhang ZL, Li R, Yang FY, et al. Natriuretic peptide family as diagnostic/prognostic biomarker and treatment modality in management of adult and geriatric patients with heart failure: Remaining issues and challenges. J Geriatr Cardiol, 2018, 15(8): 540-546.
30. Sinner MF, Stepas KA, Moser CB, et al. B-type natriuretic peptide and C-reactive protein in the prediction of atrial fibrillation risk: The CHARGE-AF Consortium of community-based cohort studies. Europace, 2014, 16(10): 1426-1433.
31. Gao H, Zhang N, Lu F, et al. Circulating histones for predicting prognosis after cardiac surgery: A prospective study. Interact Cardiovasc Thorac Surg, 2016, 23(5): 681-687.
32. Brandstrup B, Beier-Holgersen R, Iversen LH, et al. The influence of perioperative fluid therapy on N-terminal-pro-brain natriuretic peptide and the association with heart and lung complications in patients undergoing colorectal surgery: Secondary results of a clinical randomized assessor-blinded multicenter trial. Ann Surg, 2020, 272(6): 941-949.
33. Stokes NR, Dietz BW, Liang JJ. Cardiopulmonary laboratory biomarkers in the evaluation of acute dyspnea. Open Access Emerg Med, 2016, 8: 35-45.
34. Khan A, Johnson DK, Carlson S, et al. NT-pro BNP predicts myocardial injury post-vascular surgery and is reduced with CoQ 10: A randomized double-blind trial. Ann Vasc Surg, 2020, 64: 292-302.
35. Kawagoe C, Sato Y, Toida T, et al. N-terminal-pro-B-type-natriuretic peptide associated with 2-year mortality from both cardiovascular and non-cardiovascular origins in prevalent chronic hemodialysis patients. Ren Fail, 2018, 40(1): 127-134.
36. Wei XB, Liu YH, He PC, et al. Prognostic value of N-terminal prohormone brain natriuretic peptide for in-hospital and long-term outcomes in patients with infective endocarditis. Eur J Prev Cardiol, 2017, 24(7): 676-684.
37. Stienen S, Salah K, Moons AH, et al. NT-proBNP (N-Terminal pro-B-type natriuretic peptide)-guided therapy in acute decompensated heart failure: PRIMA Ⅱ randomized controlled trial (Can NT-ProBNP-guided therapy during hospital admission for acute decompensated heart failure reduce mortality and readmissions?). Circulation, 2018, 137(16): 1671-1683.
38. Felker GM, Anstrom KJ, Adams KF, et al. Effect of natriuretic peptide-guided therapy on hospitalization or cardiovascular mortality in high-risk patients with heart failure and reduced ejection fraction: A randomized clinical trial. JAMA, 2017, 318(8): 713-720.
39. McLellan J, Bankhead CR, Oke JL, et al. Natriuretic peptide-guided treatment for heart failure: A systematic review and meta-analysis. BMJ Evid Based Med, 2020, 25(1): 33-37.
40. Dandamudi S, Chen HH. The ASCEND-HF trial: An acute study of clinical effectiveness of nesiritide and decompensated heart failure. Expert Rev Cardiovasc Ther, 2012, 10(5): 557-563.
41. Gong B, Wu Z, Li Z. Efficacy and safety of nesiritide in patients with decompensated heart failure: A meta-analysis of randomised trials. BMJ Open, 2016, 6(1): e008545.
42. Strain WD. The use of recombinant human B-type natriuretic peptide (nesiritide) in the management of acute decompensated heart failure. Int J Clin Pract, 2004, 58(11): 1081-1087.
43. Lee CY, Huntley BK, McCormick DJ, et al. Cenderitide: Structural requirements for the creation of a novel dual particulate guanylyl cyclase receptor agonist with renal-enhancing in vivo and ex vivo actions. Eur Heart J Cardiovasc Pharmacother, 2016, 2(2): 98-105.
44. Kawakami R, Lee CYW, Scott C, et al. A human study to evaluate safety, tolerability, and cyclic GMP activating properties of cenderitide in subjects with stable chronic heart failure. Clin Pharmacol Ther, 2018, 104(3): 546-552.
45. McMurray JJ, Packer M, Desai AS, et al. Baseline characteristics and treatment of patients in prospective comparison of ARNI with ACEI to determine impact on global mortality and morbidity in heart failure trial (PARADIGM-HF). Eur J Heart Fail, 2014, 16(7): 817-825.
46. Solomon SD, McMurray JJV, Anand IS, et al. Angiotensin-neprilysin inhibition in heart failure with preserved ejection fraction. N Engl J Med, 2019, 381(17): 1609-1620.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical research progress on brain natriuretic peptide and amino-terminal pro-brain natriuretic peptide

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