The Differences of Average Level Serum N Terminal Prob-Type Natriuretic Peptide (NTPROBNP) in Hypertension Patients with and without Left Ventricular Hypertrophy At Cardiology Outpatients Dr. Sardjito General Hospital Yogyakarta

https://doi.org/10.22146/acta%20interna.22350

Gusti Hariadi Maulana(1*), Lucia Krisdinarti(2), Hariadi Hariawan(3)

(1) 
(2) 
(3) 
(*) Corresponding Author

Abstract


Introduction. Hypertension cause changes in the structure and function of cardial as triggers neurohormonal and vascular changes that concentric cardiac hypertrophy. Myocyte volume expansion or increased pressure will trigger the synthesis of pre-proBrain Natriuretic Peptide (BNP) in the ventricular myocardium. Pre-proBNP will be converted into proBNP and proBNP will be converted into the form of BNP and N-terminal proBNP (NT proBNP).


Aim. This study aimed to determine differences in BT pro BNP in hypertensive patients without LVH and hypertensive patients with LVH. The study design was cross-sectional in cardiology polyclinic`s outpatient at Dr. Sardjito General Hospital Yogyakarta from August 2009 until the sample number is fulfi lled.

Method. To analyze the difference between the two groups of hypertensive patients using the t-test for normal distribution, while for abnormal distribution were analyzed with the Mann-Whitney U test. To analyze the normality of data conducted by Kolmogorov-Smirnov. The differences of two groups of hypertensive patients considered as signifi cant if p < 0.005 with confi dence interval of 95%.


Results. The results showed 73 study subjects grouped subjects into 2 groups: hypertensive subjects without LVH (31 subjects) and with LVH (42 subjects) based on echocardiography parameters (IVSD, LVPWd, LVIDd, LVM, and LVMI) consisting of 24 males and 49 females. The baseline characteristics between the study groups of hypertensive subjects with and without LVH did not differ signifi cantly either in age, BMI, blood pressure, duration of hypertention therapeutic characteristics of the use of drugs such as ACEI, ARB, β-blocker, CCB, spironolactone and furosemide. Mean NT proBNP levels in hypertensive group without LVH (46.60 ± 45.51) and hypertention with LVH group (201.60 ±192.30 ng/ml). From the results of the Kolmogrov-Smirnov test result that the data distribution was not normal then used Mann-Whitney U test, obtained a statistically significant differences.


Conclusion. There were significant differences in the mean levels of serum NT proBNP in hypertensive patients without LVH and hypertensive patients with LVH.

 


Keywords


hypertension, left ventricular hypertrophy (LVH), N-terminal proBrain natriuretic Peptide, Internal medicine; pulmonology; endocrinology; Internal Medicine; hematology and medical oncology; gastro entero hepatology; geriatric; rheumatology, cardiology

Full Text:

PDF


References

Chobanian, AV., Bakris, GL., Black, HR., 2003. Seventh report of the joint national committee on prevention, detection, and treatment of high blood pressure. JAMA 289:1206-112.

Rahajeng, E., 2009, Masalah hipertensi di Indonesia, http://digilib.litbang.depkes.go.id, cited 27 Maret 2011

Corretero, O.A., Oparil, S., 2000, Essential hypertension, Part I: Definition and etiology, Circulation;101:329-335.

Riaz, K., Ahmed, A., 2010. Hypertensive heart disease, http://emedicine. medscape.com/article/162449-overview

Scaglione, R., Argano, C., Di Chiara, T., Colomba, D., Avellone, G., Donatelli, M., Corrao, S., Licata, G., 2007, Effect of dual blockade of renin-angiotensin system on TGF β1 and left ventricular structure and function in hypertensive patients, Journal of Human hypertension 21: 307-315, Nature Publishing Group, www.nature.com/jnh

Augusts, P.,2004. Overview: Mechanism of Hypertension: Cells, Hormones, and the Kidney. J Am Soc Nephrol 15:1971.

Daniels, LB., Maisel, AS., 2007. Natriuretic peptides. JACC 50:2357-68.

Davidson, N.C., Barr, C.S., Struthers, A.D., 1996, C-type natriuretic peptide an endogeneous inhibitor of vascular angiotensin-converting enzyme activity, Circulation;93:1155-1159.

DeFilippi, C., 2005. Application of NT-proBNP as a Diagnostic Marker of Cardiac Disease. Medscape [updated 2005; cited];.Available from: http://www.Medscape.com.

Belluardo, P., Cataliotti, A., Bonaiuto,L., 2006. Lack of activation of molecular forms of the BNP system in human grade I hypertension and relationship to cardiac hypertrophy. Am J Physiol Heart Circ 291:1529-34.

Schirmer, H., Lunde, P., Rasmussen, K., 1999, Prevalence of left ventricular hypertrophy in general population, European Heart Journal 20:429-438, http://www.fac.org.ar/scvc/llav/PDF/tl222i.PDF.

Maric, C., 2005, Sex differences in cardiovascular and hypertension :involvement of the renin-angiotensin system, American Heart Assosiation, Hypertension 46:475-476.

Nardi, E., Palermo, A., Mule, G., Cusimano, P., Cerasola, G.,Rini, G.V., 2012, Prevalence and predictor of left ventricular hypertrophy in patients with hypertension and normal electrocardiogram, European Journal of Preventive Cardiology, May 3, http://cpr.sagepub.com/content/early/2012/05/02/2047487312447845.abstract)

Gaddam, K.K., Eduardo, P., Inusah, S., Gupta, H., Lloyd, S.G., Oparil, S., Dell’Italia, L.J., Calhoun, D.A., 2007, Spironolactone improves blood pressure and left ventricular hypertrophy in patients with resistant hypertension, In:Hypertension. Proceedings of: 61st Annual High Blood Pressure Conference 2007. 61st Annual High Blood Pressure Conference 2007, Tucson, AZ, USA, (e130-e130). 26-29 September 2007.

Willis, KS., Domenica, AS., 2008. Endogenous Natriuretic Peptide in Hypertension Primer 4 ed. Philadelphia: Lippincot William & Wilkins; p.86-87.



DOI: https://doi.org/10.22146/acta%20interna.22350

Article Metrics

Abstract views : 1181 | views : 567

Refbacks

  • There are currently no refbacks.




Copyright (c) 2017 Acta Interna The Journal of Internal Medicine

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Acta Interna The Journal of Internal Medicine Indexed by:

 

 Indonesia Onesearch Google Scholar IPI Indonesian Publication Index

 website statistics View My Stats  

 

 

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.