Submitted on March 24, 2008
Revised on September 18, 2008
Accepted on October 1, 2008
Plasma NT-proBNP increases in response to LPS administration in healthy men
Greisa Vila1, Michael Resl2, David Stelzeneder2, Joachim Struck3, Christina Maier2, Michaela Riedl2, Martin Hülsmann2, Richard Pacher2, Anton Luger2, and Martin Clodi2*
1 Medical University Vienna
2 Medical University of Vienna
3 BRAHMS AG
* To whom correspondence should be addressed. E-mail: martin.clodi{at}meduniwien.ac.at.
Circulating levels of B-type natriuretic peptide (BNP) and N-terminal-proBNP (NT-proBNP) increase in response to volume overload and help in the differential diagnosis of acute heart failure. Elevated plasma BNP levels are observed also in sepsis and do not always correspond to left ventricular dysfunction. Here we investigated plasma NT-proBNP fluctuations in response to human bacterial endotoxinemia, an experimental model of systemic infection and inflammation. 2 ng/kg <I>Escherichia coli</I> endotoxin (LPS) was administered to ten healthy volunteers in a randomized, placebo-controlled, crossover design. Plasma NT-proBNP, C-reactive protein (CRP), C-terminal pro-endothelin-1 (CT-proET-1) and midregional-pro-adrenomedullin (MR-proADM) were measured at hourly intervals for 6 hours. LPS administration induced a continuous increase in plasma NT-proBNP that reached peak values after 6 hours (40.7 ± 7.9 vs. 16.1 ± 3.2 pg/ml in placebo days, mean ± SE, P=0.023). The profile of changes in NT-proBNP correlated to changes in body temperature (P<0.001), heart rate (P=0.005), CRP (P<0.001) and in CT-proET-1 (P=0.008), but not to blood pressure values. Our results demonstrate that plasma NT-proBNP increases in a model of systemic infection/inflammation in healthy men with normal heart function. This finding emphasizes the necessity to consider concomitant infections when interpreting elevated circulating NT-proBNP concentrations.
