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01.10.2003 | Original

Plasma atrial natriuretic peptide and brain natriuretic peptide are increased in septic shock: impact of interleukin-6 and sepsis-associated left ventricular dysfunction

verfasst von: Rochus Witthaut, Christian Busch, Peter Fraunberger, Autar Walli, Dietrich Seidel, Günter Pilz, Ralph Stuttmann, Norbert Speichermann, Ljifane Verner, Karl Werdan

Erschienen in: Intensive Care Medicine | Ausgabe 10/2003

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Abstract

Objective

Interest has recently focused on the use of neurohormonal markers such as atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) as indices of left ventricular systolic dysfunction and prognosis in heart failure. Also, peptides belonging to the interleukin-6 (IL-6) family have been shown to induce ANP and BNP secretion. We hypothesized that BNP and ANP spillover in the peripheral circulation reflects left ventricular dysfunction and IL-6 production in septic shock.

Design and setting

Retrospective, clinical study in the medical intensive care unit of a university hospital.

Patients and participants

17 patients with septic shock and 19 control subjects.

Interventions

Collection of clinical and demographic data in relation to ANP, BNP, IL-6, and soluble TNF receptors (sTNF-R-p55, sTNF-R-p75) in plasma over a period of 4 days.

Measurements and results

In septic shock we found a significant increase in ANP (82.7±9.9 vs. 14.9±1.2 pg/ml) and BNP (12.4±3.6 vs. 5.5±0.7 pg/ml). Plasma ANP peaked together with IL-6. Peaks of ANP and IL-6 were significantly correlated (r=0.73; p<0.01). BNP was inversely correlated to cardiac index (r=–0.56; p<0.05).

Conclusions

ANP and BNP increase significantly in patients with septic shock. BNP reflects left ventricular dysfunction. ANP is related to IL-6 production rather than to cardiovascular dysfunction.

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Titel: Plasma atrial natriuretic peptide and brain natriuretic peptide are increased in septic shock: impact of interleukin-6 and sepsis-associated left ventricular dysfunction
verfasst von: Rochus Witthaut
Christian Busch
Peter Fraunberger
Autar Walli
Dietrich Seidel
Günter Pilz
Ralph Stuttmann
Norbert Speichermann
Ljifane Verner
Karl Werdan
Publikationsdatum: 01.10.2003
Verlag: Springer-Verlag
Erschienen in: Intensive Care Medicine / Ausgabe 10/2003
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-003-1910-0

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Plasma atrial natriuretic peptide and brain natriuretic peptide are increased in septic shock: impact of interleukin-6 and sepsis-associated left ventricular dysfunction