Association between left ventricular reverse remodelling and the B-type natriuretic peptide–cGMP cascade after anterior acute myocardial infarction

Background The role of cyclic guanosine 3′,5′-monophosphate (cGMP) after acute myocardial infarction (AMI) is not well understood despite its significance as a second messenger of natriuretic peptides (NPs) in cardiovascular disease. We investigated the association between the NP-cGMP cascade and le...

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Main Authors: Satoshi Yasuda, Kunihiro Nishimura, Kensuke Takagi, Hiroyuki Takahama, Naoto Minamino, Masashi Fujino, Satoshi Honda, Yasuhide Asaumi, Yu Kataoka, Fumiyuki Otsuka, Soshiro Ogata, Teruo Noguchi, Takahiro Nakashima, Kenichiro Sawada, Yoshiaki Morita, Kazuhiro Nakao, Hiroyuki Miura, Takamasa Iwai, Marina Arai, Eri Kiyoshige, Kota Murai, Hideo Matama, Shuichi Yoneda
Format: Article
Language:English
Published: BMJ Publishing Group 2025-01-01
Series:Open Heart
Online Access:https://openheart.bmj.com/content/12/1/e002927.full
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author Satoshi Yasuda
Kunihiro Nishimura
Kensuke Takagi
Hiroyuki Takahama
Naoto Minamino
Masashi Fujino
Satoshi Honda
Yasuhide Asaumi
Yu Kataoka
Fumiyuki Otsuka
Soshiro Ogata
Teruo Noguchi
Takahiro Nakashima
Kenichiro Sawada
Yoshiaki Morita
Kazuhiro Nakao
Hiroyuki Miura
Takamasa Iwai
Marina Arai
Eri Kiyoshige
Kota Murai
Hideo Matama
Shuichi Yoneda
author_facet Satoshi Yasuda
Kunihiro Nishimura
Kensuke Takagi
Hiroyuki Takahama
Naoto Minamino
Masashi Fujino
Satoshi Honda
Yasuhide Asaumi
Yu Kataoka
Fumiyuki Otsuka
Soshiro Ogata
Teruo Noguchi
Takahiro Nakashima
Kenichiro Sawada
Yoshiaki Morita
Kazuhiro Nakao
Hiroyuki Miura
Takamasa Iwai
Marina Arai
Eri Kiyoshige
Kota Murai
Hideo Matama
Shuichi Yoneda
author_sort Satoshi Yasuda
collection DOAJ
description Background The role of cyclic guanosine 3′,5′-monophosphate (cGMP) after acute myocardial infarction (AMI) is not well understood despite its significance as a second messenger of natriuretic peptides (NPs) in cardiovascular disease. We investigated the association between the NP-cGMP cascade and left ventricular reverse remodelling (LVRR) in anterior AMI.Methods 67 patients with their first anterior AMI (median age, 64 years; male, 76%) underwent prospective evaluation of plasma concentrations of the molecular forms of A-type and B-type natriuretic peptide (BNP) and cGMP from immediately after primary percutaneous coronary intervention (PPCI) to 10 months post-AMI. The estimated mature BNP (emBNP) concentration was calculated as the difference between total BNP and prohormone of BNP (proBNP) concentrations. Patients were divided into LVRR and non-LVRR groups on the basis of residuals between observed change in left ventricular end-systolic volume index on MR during the first 11 months after AMI and change adjusted for proBNP concentration immediately post-PPCI, which was calculated with regression. The LVRR group (n=33) had residuals below the median; the non-LVRR group (n=34) had residuals at or above the median.Results The LVRR group had higher freedom from major adverse cardiac and cerebrovascular events (MACCEs) than the non-LVRR group during a median follow-up of 9.9 years (p=0.008). The presence of LVRR (HR 0.256; 95% CI 0.081 to 0.809; p=0.028) and peak creatine phosphokinase–myocardial band level (per 100 IU/L) (HR 1.22; 95% CI 1.02 to 1.46; p=0.027) were independent predictors of MACCE after adjusting for age, male sex, infarct size and hypertension. Multivariable analyses identified logarithmic proBNP and emBNP concentrations from 12 hours to 5 days post-AMI and logarithmic cGMP concentration from immediately post-PPCI to 3 days post-AMI as independent predictors of LVRR (p<0.05).Conclusions Early-phase BNP-cGMP cascade activation might play a crucial role in LVRR in anterior AMI.
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spelling doaj-art-ff0962bade9c4608acccfa70ac127cca2025-01-15T02:45:08ZengBMJ Publishing GroupOpen Heart2053-36242025-01-0112110.1136/openhrt-2024-002927Association between left ventricular reverse remodelling and the B-type natriuretic peptide–cGMP cascade after anterior acute myocardial infarctionSatoshi Yasuda0Kunihiro Nishimura1Kensuke Takagi2Hiroyuki Takahama3Naoto Minamino4Masashi Fujino5Satoshi Honda6Yasuhide Asaumi7Yu Kataoka8Fumiyuki Otsuka9Soshiro Ogata10Teruo Noguchi11Takahiro Nakashima12Kenichiro Sawada13Yoshiaki Morita14Kazuhiro Nakao15Hiroyuki Miura16Takamasa Iwai17Marina Arai18Eri Kiyoshige19Kota Murai20Hideo Matama21Shuichi Yoneda22Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan2 Department of Statistics and Data Analysis, Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center, Suita, Osaka, JapanDepartment of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan1 Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan3 Department of Molecular Pharmacology, National Cerebral and Cardiovascular Center, Suita, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, JapanDepartment of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, JapanDepartment of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USADepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan2The Department of Radiology, National Cerebral and Cardiovascular Centre, Suita, JapanLeeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UKDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, JapanDepartment of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, JapanBackground The role of cyclic guanosine 3′,5′-monophosphate (cGMP) after acute myocardial infarction (AMI) is not well understood despite its significance as a second messenger of natriuretic peptides (NPs) in cardiovascular disease. We investigated the association between the NP-cGMP cascade and left ventricular reverse remodelling (LVRR) in anterior AMI.Methods 67 patients with their first anterior AMI (median age, 64 years; male, 76%) underwent prospective evaluation of plasma concentrations of the molecular forms of A-type and B-type natriuretic peptide (BNP) and cGMP from immediately after primary percutaneous coronary intervention (PPCI) to 10 months post-AMI. The estimated mature BNP (emBNP) concentration was calculated as the difference between total BNP and prohormone of BNP (proBNP) concentrations. Patients were divided into LVRR and non-LVRR groups on the basis of residuals between observed change in left ventricular end-systolic volume index on MR during the first 11 months after AMI and change adjusted for proBNP concentration immediately post-PPCI, which was calculated with regression. The LVRR group (n=33) had residuals below the median; the non-LVRR group (n=34) had residuals at or above the median.Results The LVRR group had higher freedom from major adverse cardiac and cerebrovascular events (MACCEs) than the non-LVRR group during a median follow-up of 9.9 years (p=0.008). The presence of LVRR (HR 0.256; 95% CI 0.081 to 0.809; p=0.028) and peak creatine phosphokinase–myocardial band level (per 100 IU/L) (HR 1.22; 95% CI 1.02 to 1.46; p=0.027) were independent predictors of MACCE after adjusting for age, male sex, infarct size and hypertension. Multivariable analyses identified logarithmic proBNP and emBNP concentrations from 12 hours to 5 days post-AMI and logarithmic cGMP concentration from immediately post-PPCI to 3 days post-AMI as independent predictors of LVRR (p<0.05).Conclusions Early-phase BNP-cGMP cascade activation might play a crucial role in LVRR in anterior AMI.https://openheart.bmj.com/content/12/1/e002927.full
spellingShingle Satoshi Yasuda
Kunihiro Nishimura
Kensuke Takagi
Hiroyuki Takahama
Naoto Minamino
Masashi Fujino
Satoshi Honda
Yasuhide Asaumi
Yu Kataoka
Fumiyuki Otsuka
Soshiro Ogata
Teruo Noguchi
Takahiro Nakashima
Kenichiro Sawada
Yoshiaki Morita
Kazuhiro Nakao
Hiroyuki Miura
Takamasa Iwai
Marina Arai
Eri Kiyoshige
Kota Murai
Hideo Matama
Shuichi Yoneda
Association between left ventricular reverse remodelling and the B-type natriuretic peptide–cGMP cascade after anterior acute myocardial infarction
Open Heart
title Association between left ventricular reverse remodelling and the B-type natriuretic peptide–cGMP cascade after anterior acute myocardial infarction
title_full Association between left ventricular reverse remodelling and the B-type natriuretic peptide–cGMP cascade after anterior acute myocardial infarction
title_fullStr Association between left ventricular reverse remodelling and the B-type natriuretic peptide–cGMP cascade after anterior acute myocardial infarction
title_full_unstemmed Association between left ventricular reverse remodelling and the B-type natriuretic peptide–cGMP cascade after anterior acute myocardial infarction
title_short Association between left ventricular reverse remodelling and the B-type natriuretic peptide–cGMP cascade after anterior acute myocardial infarction
title_sort association between left ventricular reverse remodelling and the b type natriuretic peptide cgmp cascade after anterior acute myocardial infarction
url https://openheart.bmj.com/content/12/1/e002927.full
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