Plasma brain natriuretic peptide is a biochemical marker for the prediction of progressive ventricular remodeling after acute myocardial infarction

To investigate the relation between plasma brain natriuretic peptide (BNP) and progressive ventricular remodeling, we measured plasma BNP and atrial natriuretic peptide (ANP) in 30 patients with acute myocardial infarction on days 2, 7, 14, and 30 after the onset. left ventricular end-diastolic volume index (EDVI), end-systolic volume index (ESVI), and election Fraction (EF) on admission and 1 month after the onset were assessed by left ventriculography. Changes in EDVI (Delta EDVI), ESVI (Delta ESVI), and EF (Delta EF) were obtained by subtracting respective acute-phase values from corresponding chronic-phase values. Plasma ANP on days 2 and 7 showed only weak correlations with Delta EDVI (r = 0.48 and 0.54; both p < 0.01), whereas plasma BNP on day 7 more closely correlated with Delta EDVI (r = 0.77; p < 0.001). When study patients were divided into two groups according to plasma BNP on day 7, the group with BNP higher than 100 pg/ml showed greater increases in left ventricular volume and less improvement in EF compared with the other group with BNP lower than 100 pg/ml (Delta EDVI = 10.4 +/- 8 vs -3.4 +/- 9 ml/m(2), Delta ESVI = 6.2 +/- 7 vs -4.9 +/- 5 ml/m(2), and Delta EF = 1.0% +/- 4% vs 4.9% +/- 5%; p < 0.05, respectively). Multiple regression analysis revealed that only plasma BNP on day 7, but not ANP, peak creatine phosphokinase level, left ventricular end-diastolic pressure, or acute-phase EF, correlated independently with Delta EDVI (p < 0.01). These results suggest that plasma BNP may be a simple and useful biochemical marker For the prediction of progressive ventricular remodeling within the first 30 days of acute myocardial infarction.