atrial-natriuretic-factor and Dementia

Background Elevated natriuretic peptides (NP) are associated with adverse cerebrovascular conditions including stroke, cerebral small vessel disease, and dementia. However, the mechanisms underlying these associations remain unclear. In this study, we examined the relationship of NT-proBNP (N-terminal pro brain NP) and NT-proANP (N-terminal pro atrial NP) with cerebrovascular function, measured by cerebral autoregulation. Methods and Results We included 154 participants (mean age 56±4 years old) from the CARDIA (Coronary Artery Risk Development in Young Adults) cohort. NT-proBNP and NT-proANP were measured in blood samples from the year 25 examination using electrochemiluminescence Immunoassay and enzyme-linked immunoassay, respectively. Dynamic cerebral autoregulation (dCA) was assessed at the year 30 examination by transcranial Doppler ultrasound, using transfer function analysis (phase and gain) of spontaneous blood pressure and flow velocity oscillations, where lower phase and higher gain reflect less efficient cerebral autoregulation. We used multivariable linear regression models adjusted for demographics, vascular risk factors, and history of kidney and cardiac diseases. Higher NT-proBNP levels at year 25 were associated with lower phase (β [95% CI]=-5.30 lower degrees of phase [-10.05 to -0.54]) and higher gain (β [95% CI]=0.06 higher cm/s per mm Hg of gain [0.004-0.12]) at year 30. Similarly, higher NT-proANP levels were associated with lower phase (β [95% CI]=-9.08 lower degrees of phase [-16.46 to -1.70]). Conclusions Higher circulating levels of NT-proBNP and NT-proANP are associated with less efficient dCA 5 years later. These findings link circulating NP to cerebral autoregulation and may be one mechanism tying NP to adverse cerebrovascular outcomes.

Topics: Atrial Natriuretic Factor; Blood Flow Velocity; Brain; Cerebrovascular Circulation; Cerebrovascular Disorders; Dementia; Female; Heart Disease Risk Factors; Homeostasis; Humans; Longitudinal Studies; Male; Middle Aged; Middle Cerebral Artery; Natriuretic Peptide, Brain; Peptide Fragments; Ultrasonography, Doppler, Transcranial; United States

Cerebral endothelial dysfunction occurs in a spectrum of neurodegenerative diseases. Whether biomarkers of microvascular endothelial dysfunction can predict dementia is largely unknown. We explored the longitudinal association of midregional pro-atrial natriuretic peptide (MR-proANP), C-terminal endothelin-1 (CT-proET-1) and midregional proadrenomedullin (MR-proADM) with dementia and subtypes amongst community-dwelling older adults.. A population-based cohort of 5347 individuals (men, 70%; age, 69 ± 6 years) without prevalent dementia provided plasma for determination of MR-proANP, CT-proET-1 and MR-proADM. Three-hundred-and-seventy-three patients (7%) were diagnosed with dementia (120 Alzheimer's disease, 83 vascular, 102 mixed, and 68 other aetiology) over a period of 4.6 ± 1.3 years. Relations between baseline biomarker plasma concentrations and incident dementia were assessed using multivariable Cox regression analysis.. Higher levels of MR-proANP were significantly associated with increased risk of all-cause and vascular dementia (hazard ratio [HR] per 1 SD: 1.20, 95% confidence interval [CI], 1.07-1.36; P = 0.002, and 1.52; 1.21-1.89; P < 0.001, respectively). Risk of all-cause dementia increased across the quartiles of MR-proANP (p for linear trend = 0.004; Q4, 145-1681 pmol L. Elevated plasma concentration of MR-proANP is an independent predictor of all-cause and vascular dementia. Pronounced increase in CT-proET-1 indicates higher risk of vascular dementia.

Topics: Adrenomedullin; Aged; Atrial Natriuretic Factor; Biomarkers; Brain; Dementia; Endothelin-1; Endothelium, Vascular; Female; Follow-Up Studies; Humans; Male; Peptide Fragments; Prospective Studies; Protein Precursors; Risk Factors

High plasma brain natriuretic peptide (BNP) concentrations have been observed in patients with ischemic stroke, as well as cardiovascular disease. Furthermore, a recent report suggests that BNP may predict cognitive dysfunction in older patients with cardiovascular disease. The purpose of this study is to estimate the clinical impression of brain natriuretic peptide (BNP) in demented patients without cardiovascular disease.. The Revised Hasegawa Dementia Scale (HDS-R), age, echocardiographic parameters, and plasma atrial natriuretic peptide (ANP) and BNP levels were assessed in 42 outpatients at the Dementia Care Unit in Watanabe Hospital.. Some BNP levels were more than normal reference values, while any ANP levels were no more than normal reference values. BNP levels were significantly correlated (i.e. negative correlation) with HDS-R (r = -0.33, P = 0.03), whereas those were not significantly correlated with age and echocardiographic parameters.. This study shows that BNP levels were significantly correlated with cognitive function in demented patients without cardiovascular disease, and suggests that BNP may support the assessment of cognitive dysfunction in demented patients.

Topics: Aged; Atrial Natriuretic Factor; Cardiovascular Diseases; Cognition Disorders; Dementia; Female; Humans; Male; Natriuretic Peptide, Brain

Topics: Aged; Atrial Natriuretic Factor; Dementia; Female; Humans; Male; Middle Aged; Plasma; Psychiatric Status Rating Scales