Obesity and suppressed B-type natriuretic peptide levels in heart failure

Mehra, Mandeep R., Uber, Patricia A., Park, Myung H., Scott, Robert L., Ventura, Hector O., Harris, Bobbett C. and Frohlich, Edward D. (2004) Obesity and suppressed B-type natriuretic peptide levels in heart failure. Journal of the American College of Cardiology, 43 9: 1590-1595. doi:10.1016/j.jacc.2003.10.066

Author Mehra, Mandeep R.
Uber, Patricia A.
Park, Myung H.
Scott, Robert L.
Ventura, Hector O.
Harris, Bobbett C.
Frohlich, Edward D.
Title Obesity and suppressed B-type natriuretic peptide levels in heart failure
Journal name Journal of the American College of Cardiology   Check publisher's open access policy
ISSN 0735-1097
Publication date 2004-05
Sub-type Article (original research)
DOI 10.1016/j.jacc.2003.10.066
Volume 43
Issue 9
Start page 1590
End page 1595
Total pages 6
Place of publication San Diego, CA, United States
Publisher Elsevier
Language eng
Formatted abstract
Objectives: This investigation evaluated the relationship between obesity and B-type natriuretic peptide (BNP) in heart failure.

Background: Obesity is a major risk factor for the development of heart failure, but the precise mechanisms remain uncertain. Physiologically, natriuretic peptides and lipolysis are closely linked.

Methods: A total of 318 patients with heart failure were evaluated between June 2001 and June 2002. Levels of BNP were compared in obese (body mass index [BMI] ≥30 kg/m 2) and nonobese (BMI <30 kg/m 2) patients with respect to New York Heart Association functional class and lean body weight-adjusted peak aerobic oxygen consumption. In a subset of 36 patients, plasma levels of tumor necrosis factor-alpha, interleukin-6, and soluble intercellular adhesion molecule-1 were measured.

Results: The population's BMI was 29.4 ± 6.6 kg/m 2; 24% were lean (BMI <25 kg/m 2), 31% overweight (BMI ≥25 to 29.9 kg/m 2), and 45% obese (BMI ≥30 kg/m 2). Obese patients were younger, more often African American, and more likely to have a history of antecedent hypertension, but less likely to have coronary artery disease and with only a trend toward diabetes mellitus. Levels of BNP were significantly lower in obese than in nonobese subjects (205 ± 22 and 335 ± 39 pg/ml, respectively; p = 0.0007), despite a similar severity of heart failure and cytokine levels. Multivariate regression analysis identified BMI as an independent negative correlate of BNP level. There were no differences in emergency department visits, heart failure hospitalization, or death between the obese and nonobese patients at 12-month follow-up.

Conclusions: Our investigation indicates that a state of reduced natriuretic peptide level exists in the obese individual with heart failure.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Created: Mon, 14 Mar 2011, 10:10:46 EST