CHANGES OF PLASMA BRAIN NATRIURETIC PEPTIDE (BNP) CONCENTRATION IN SHORT TIME MYOCARDIAL ISCHEMIA BY PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY

Abstract

The feasibility of using the plasma brain natriuretic peptide (BNP) level as an index of a brief myocardial ischemia was evaluated. The subjects were seven patients undergoing elective percutaneous transluminal coronary angioplasty (PTCA), comprising three with old myocardial infarction and four with angina pectoris. In all patients exercise myocardial scintigraphy showed transient myocardial ischemia in the regions supplied by stenotic coronary arteries. With PTCA, one session of dilatation was performed for 1min to improve stenosis to 25% or less. Before and after PTCA, the peripheral and coronary sinus plasma levels of BNP were measured. The relationship was assessed between BNP levels and the left ventricular ejection fraction (LVEF) or left ventricular enddiastolic pressure (LVEDP) measured by diagnostic cardiac catheter. Both peripheral and coronary sinus plasma BNP levels did not change significantly after PTCA and showed no significant correlation with LVEF or LVEDP. The use of plasma BNP as an index of the effect on the left ventricle of brief myocardial ishemia during PTCA appears to have its limitations.