Amino-Terminal Pro-B-Type Brain Natriuretic Peptide: Screening for Cardiovascular Disease in the Setting of Alcoholism

• Published in: Alcohol and alcoholism (Oxford) Vol. 46; no. 3; pp. 247 - 252
• Main Authors: HÖFER, Peter, SYEDA, Bonni, BERGLER-KLEIN, Jutta, FRIEDRICH, Fabian, LESCH, Otto Michael, VYSSOKI, Benjamin, BINDER, Thomas, WALTER, Henriette
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01-05-2011
• Subjects: Addictive behaviors; Adult; Adult and adolescent clinical studies; Aged; Alcoholism; Alcoholism - epidemiology; Alcoholism - metabolism; Alcoholism - rehabilitation; Alcoholism and acute alcohol poisoning; Biological and medical sciences; Biomarkers - blood; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - metabolism; Central Nervous System Depressants - adverse effects; Central Nervous System Depressants - blood; Central Nervous System Depressants - pharmacology; Comorbidity; Echocardiography; Ethanol - adverse effects; Ethanol - blood; Ethanol - pharmacology; Female; Heart Failure - diagnosis; Heart Failure - diagnostic imaging; Heart Failure - physiopathology; Humans; Hypertension - epidemiology; Hypertension - physiopathology; Male; Medical sciences; Middle Aged; Natriuretic Peptide, Brain - blood; Natriuretic Peptide, Brain - physiology; Peptide Fragments - blood; Peptide Fragments - physiology; Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Stroke Volume - drug effects; Toxicology; Brain natriuretic peptide; Cardiovascular disease; Medical screening; Pro-B lymphocyte; Alcoholism
• ISSN: 0735-0414; 1464-3502
• DOI: 10.1093/alcalc/agr027

N-terminal pro-BNP (NtBNP) has attracted attention as a biomarker for heart failure. The aims of our study are (a) to characterize the role of NtBNP as a biological marker in the setting of alcoholism; (b) to describe potential gender differences with respect to NtBNP; (c) to correlate NtBNP with other clinical and haemodynamic variables.
We examined 83 alcohol-dependent patients according to International Classification of Disease 10th Revision (ICD-10) and Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV; 59 males and 24 females, age: 50 ± 10.5 years) referred to the department of psychiatry for alcohol withdrawal therapy. In these patients, we determined NtBNP, markers of alcohol abuse and transthoracic echocardiography to determine systolic left ventricular ejection fraction (EF). These measurements were repeated after alcohol withdrawal.
At Day 1 of alcohol withdrawal, 43 patients (52%; 27 males and 16 females) had elevated NtBNP levels (394.4 ± 438.7 pg/ml) despite normal EF (64.7 ± 6.2%). After withdrawal therapy (16.6 ± 7.8 days), NtBNP decreased significantly (228.6 ± 251.2 pg/ml; P < 0.01), despite unchanged EF (65.0 ± 5.8%; P = ns). This was the case in both males and females (328.9 ± 235.5 to 216.7 ± 194.3 pg/ml; P < 0.05 vs. 492.7 ± 635.7 to 246.6 ± 327.7 pg/ml; P < 0.05). Elevated NtBNP levels were related significantly to the history of arterial hypertension (P < 0.05).
This study highlights the fact that NtBNP can be elevated in the setting of alcoholism. The elevation in NtBNP is unrelated to EF and is reversible after alcohol withdrawal. We suggest a subclinical detrimental effect of alcohol abuse on cardiac function.