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The diagnostic performance of mid-regional portion of pro-atrial natriuretic peptide for the detection of left ventricular hypertrophy in Caucasian hypertensive patients

Journal of Human Hypertension volume 26, pages 711–715 (2012)Cite this article

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Abstract

Left ventricular hypertrophy (LVH) is predictive of cardiovascular disease. The vasodilator, natriuretic and diuretic actions of atrial natriuretic peptide (ANP) support a role in the pathophysiology of hypertension. Measuring the redundant precursor fragment mid-regional portion of pro-atrial natriuretic peptide (MRproANP) overcomes the technical difficulties of quantifying the bioactive ANP. This study sought to investigate the diagnostic and prognostic utility of MRproANP in a hypertensive Caucasian patient population. A total of 194 hypertensive patients (39 patients with LVH, 69±7.82 years of age, 74% female vs 155 patients without LVH, 68±6.51 years of age, 71% female) were derived from a screening study. Plasma MRproANP concentrations were quantified using immunoluminometric assays. Hypertensive patients with LVH had higher MRproANP concentrations than those without LVH (103.04 (50.58) vs 84.11 pmol l–1 (44.82); P=0.014). Independent predictors of left ventricular mass index were LogMRproANP (P=0.022), male gender (P<0.001), body mass index (P=0.001) and history of angina or myocardial infarction (P=0.009). The receiver operating curve for MRproANP for the detection of LVH was limited, yielding an area under the curve of only 0.628 (confidence interval 0.523–0.733; P=0.014). Therefore, the role of MRproANP may not lie in the diagnosis of LVH but in monitoring the response to therapy. A nonsignificant trend towards greater mortality in patients with above-median MRproANP levels compared with below-median levels (P=0.167) was observed. Larger studies are required to assess its prognostic utility further.

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Acknowledgements

This study was supported by research grants from the Brandenburg Ministry of Economics, Germany, and the European Regional Development Fund (EFRE/ERDF). LLN is supported by the Leicester NIHR Cardiovascular Biomedical Research Unit.

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Authors and Affiliations

  1. Department of Cardiovascular Sciences, University of Leicester, Leicester, UK

    S S Bhandari, J E Davies & L L Ng

  2. Leicester NIHR Biomedical Research Unit in Cardiovascular Disease, Glenfield Hospital, Leicester, UK

    S S Bhandari, J E Davies & L L Ng

  3. B.R.A.H.M.S GmbH/Thermo Fisher Scientific, Hennigsdorf, Berlin, Germany

    J Struck

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  1. S S Bhandari
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Correspondence to S S Bhandari.

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Competing interests

JS is an employee of B.R.A.H.M.S GmbH, a company that manufactures and holds patent rights on the MRproANP assay.

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Bhandari, S., Davies, J., Struck, J. et al. The diagnostic performance of mid-regional portion of pro-atrial natriuretic peptide for the detection of left ventricular hypertrophy in Caucasian hypertensive patients. J Hum Hypertens 26, 711–715 (2012). https://doi.org/10.1038/jhh.2011.101

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