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First published November/December 2005

N-Terminal Pro-Brain Natriuretic Peptide Levels Are Elevated in Patients with Acute Ischemic Stroke

George Giannakoulas, MD, Apostolos Hatzitolios, MD, PhD, Haralambos Karvounis, MD, PhD, George Koliakos, MD, PhD, Aphrodite Charitandi, MD, PhD, Theodoros Dimitroulas, MD, Christos Savopoulos, MD, PhD, Efrosini Tsirogianni, MD, and George Louridas, MD, PhDView all authors and affiliations
Volume 56, Issue 6
https://doi.org/10.1177/000331970505600610

Abstract

Brain natriuretic peptide (BNP) is a counterregulatory hormone released by the ventricles of the heart. Its main actions are natriuresis and vasodilation. The authors studied N-terminal pro-brain natriuretic peptide (NT-proBNP) levels soon after an acute ischemic stroke. They compared plasma NT-proBNP concentrations in 30 patients with an acute ischemic stroke with those of 30 controls. The 2 groups were adjusted for age and gender, and there were no significant differences in vascular risk factors and left ventricular systolic and diastolic function. Venous samples were collected within the first 11.8 ±1.2 hours after the onset of symptoms and again on day 6. Brain computed tomography/magnetic resonance imaging (CT/MRI) was performed on the same days (day 0 and day 6) in order to assess the site (carotid or vertebrobasilar), cause (atherothrombotic, cardioembolic, or lacunar), and size (large, medium, or small) of the brain infarct. NT-proBNP levels were elevated in patients with acute stroke (129.9 ±9.9 fmol/mL) compared with the controls (90.8 ±6.3 fmol/mL, p<0.05). These levels remained elevated at day 6 (113.5 ±13.0 fmol/mL). NT-proBNP at admission was significantly higher in cardioembolic compared with atherothrombotic infarctions. There was no correlation between circulating NT-proBNP and stroke topography, infarct size, or severity as assessed by the National Institutes of Health Stroke Scale (NIHSS) at any of the 2 time points (admission and day 6). NT-proBNP levels were raised in patients with acute ischemic stroke; this effect persisted until day 6. The authors suggest that neurohumoral activation occurs in patients with acute ischemic stroke, either reflecting a counterbalancing vasodilating response to the cerebral ischemia or direct myocardial dysfunction.

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Published In

Volume 56, Issue 6
Pages: 723 - 730
Article first published: November/December 2005
Issue published: November/December 2005

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PubMed: 16327949

Authors

Affiliations

George Giannakoulas, MD
First Department of Cardiology, AHEPA General Hospital, Aristotle University of Thessaloniki, [email protected]
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Apostolos Hatzitolios, MD, PhD
First Propedeutic Department of Internal Medicine, AHEPA General Hospital, Aristotle University of Thessaloniki
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Haralambos Karvounis, MD, PhD
First Department of Cardiology, AHEPA General Hospital, Aristotle University of Thessaloniki
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George Koliakos, MD, PhD
Department of Biochemistry, Aristotle University of Thessaloniki, Greece
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Aphrodite Charitandi, MD, PhD
Radiology Department, AHEPA General Hospital, Aristotle University of Thessaloniki
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Theodoros Dimitroulas, MD
First Propedeutic Department of Internal Medicine, AHEPA General Hospital, Aristotle University of Thessaloniki
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Christos Savopoulos, MD, PhD
First Propedeutic Department of Internal Medicine, AHEPA General Hospital, Aristotle University of Thessaloniki
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Efrosini Tsirogianni, MD
First Propedeutic Department of Internal Medicine, AHEPA General Hospital, Aristotle University of Thessaloniki
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George Louridas, MD, PhD
First Department of Cardiology, AHEPA General Hospital, Aristotle University of Thessaloniki
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