We studied usefulness of serum B-type natriuretic peptide level as a screening tool for detecting hemodynamically significant patent ductus arteriosus in the preterm neonates. Sixty admitted preterm neonates with gestational age ≤34 weeks, birth weight ≤2500 gr, and age of >3 days have been enrolled in this study. We measured serum B-type natriuretic peptide levels at the beginning and after completion of drug therapy for ductus occlusion. Mean±SD gestational age and weight was 31±1.9 weeks and 1680±350 gr, respectively. The peptide levels in the neonates with significant duct (n=13) were significantly higher than in those with insignificant duct (n=17) or no duct (n=30) (1667±821 pg/ml versus 667±666 and 309±171, respectively). The peptide level dropped significantly after ibuprofen administration in the neonates with significant PDA (n=13), (1667±1165 pg/ml to 429±386). At a cutoff point of 450 pg/ml, B-type natriuretic peptide level had a sensitivity of 92% and specificity of 87%, the negative predictive value of 98.5%, the positive likelihood ratio of 6.92 and the negative likelihood ratio of 0.089 for detecting significant patent duct. Levels below this can eliminate the need for echocardiography.

There are three types of adipose tissue in the human body: white adipose tissue (WAT), brown adipose tissue (BAT) and beige or Brite adipose tissue. In WAT, energy reserves in the form of triglyceride, while in BAT triglyceride molecules lipolyze for thermogenesis through fatty acid oxidation. A protein called uncoupling protein-1 (UCP1) is responsible for non-shivering thermogenesis in BAT. The most important activators of BAT include peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α), sympathetic nervous system (SNS), hypothalamic–pituitary–thyroid axis (HPT axis), endothelium, atrial natriuretic peptides, irisin, β-aminoisobutyric acid (BAIBA), Fibroblast growth factor 21 (FGF21) and interleukin-6 (IL6) that generally exert their effects through stimulation of UCP1 expression and activity. Beige adipose are among white adipose and elevation of UCP1 gene expression is the main cause of their production that atrial natriuretic peptides, PGC1α, irisin, FGF21 and BAIBA are the most stimulators of this transformation. The role of exercise in the stimulation of BAT and transformation of WAT to Brite is discussed in this study.

Due to the significant differences between the physiology and pathology of adults and neonates, clinical guidelines for adults are not directly applicable to children. This study was performed to evaluate the effects of high- and low- dose captopril on the neonates with large left-to-right shunts. The study was conducted on 20 neonates with congenital heart disease, left-to-right shunt, and cardiac failure. Based on the Ross scoring system, the neonates were clinically evaluated by measuring renin, aldosterone, and B-type natriuretic peptide, and performing echocardiography. For each neonate, the treatment of heart failure started with digoxin and frusemide, and reevaluation was conducted 3 days after the treatment. Afterwards, the neonates were randomly divided into 2 groups; low- (0.03mg/kg) and high-doses (0.5mg/kg) of captopril were administered, and the reevaluation was carried out, after one week of therapy. The study revealed higher reduction of the Ross score in the high-dose group; however, the change was not statistically significant (P=0.56). B-type natriuretic peptide and aldosterone reduced further in the high-dose group; again the changes were not statistically significant (P=0.4). Moreover, the treatment with captopril increased the pulmonary blood flow (QP), and pulmonary-to-systemic blood flow (QP/QS) in both groups; though the changes were not significant. According to the present study, although high-dose captopril can decrease B-type natriuretic peptide and the neonates'' clinical symptoms, the resultant changes are not statistically significant. Therefore, clinical decision making should follow a case-by-case basis for each neonate, in order to select the effective dose of captopril.

Acute respiratory distress (ARD) is a critical respiratory failure due to lung injury of neonates leading to the clinical appearance of poor lung compliance. The aimed of the study was to evaluate the diagnostic values in differentiating respiratory from heart diseases with using of N-terminal pro brain natriuretic peptide (NT-pro BNP) and Atrial natriuretic peptide(ANP) in neonates.
Material and Ninety neonates randomly collected from those who hospitalized in the neonate ward of the Ali Ebne abitalib Hospital, Zahedan, Iran .After taking blood samples ANP and NT pro Brian Natriuretic peptide using ELISA kit were measured. The separated serum was kept in -20 °C until BNP measurement. 250 μl of the patients’ serum was isolated to assess pro BNP level using ELISA kit (USA). Data were analyzed using SPSS- 20 with considering of P NT pro-BNP level had the highest in cardiac patients and followed by respiratory. The level of NT pro-BNP for control neonates had the lowest. These levels had significant variation (P Many studies revealed that NT pro-BNP cannot be used as a tool for differentiation between cardiac and respiratory as a cause of respiratory distress during neonate, but the results of the present study showed that it would be good biomarker.

The present study aimed at investigating the effect of a 12-week aerobic water exercise and atorvastatin on of Atrial Natriuretic Peptide (ANP) and Brain Natriuretic Peptide (BNP) changes in older men with cardiovascular diseases.
In the current study, 40 patients with cardiovascular disease, aged 50-65yrs, who were volunteers for the research were divided in to four equal groups including1.exercise, 2.exercise plus atorvastatin, 3.atorvastatin, and 4.control. Then, blood was taken before and after the interventions. Groups 1 and 2 performed the specific water aerobic exercise 3 times a week for 12 weeks. Group 3 took 20mg of atorvastatin daily under a physician Water aerobic exercise lasted 12 weeks, 3 periods a week, with intensity of 55-60% of heart-beat. Every week, due to overtax principle, 3.5 minutes was added to exercise period. In order to determine the difference between pre-test and post-test, dependent T was applied. Intergroup difference was determined through ANOVA using Tukey for post-test; (P≤0.05).
ANOVA application revealed that mean of functional variables in pre-test compared to that of post-test was significantly different. Mean post-test of BNP in the four groups exercise, atorvastatin, exercise plus atorvastatin and control was P= 0.001, P=0.002, P=0.000, respectively. But mean post-test of ANP in the above mentioned groups was P=0.022, P=0.001, P=0.000, respectively.
Aerobic exercises together with daily taking of atorvastatin can have significant effects on decreasing natriuretic peptides and CVDs.

The aim of the present study was to investigate the effect of increasing to maximal aerobic training on biomarkers of heart damage in Iran's Premier Football League players.The present study was a semi-experimental research. From among this society, 20football players were selected as available samples. The assessment of incremental aerobic activity to the maximum was by implementing the Bruce protocol. In order to test hypotheses and compare dependent variables in different groups, analysis of variance test was used in repeated measures, and Bonferroni test was used to compare between blood sampling stages. The analysis of collected data was done using 25SPSS software.According to the results, there was no significant difference in the amount of galectin-3between the pre-test phase and immediately and 24 hours after the test. Also, there was a significant difference in CTnI and CTnT in the pre-test and after the test. CTnI and CTnT levels increased significantly immediately after the test. and then returned to the initial state 24 hours later. Also, a significant difference in brain natriuretic peptide (BNP) was observed in the pre-test, immediately and 24 hours after the exercise. Brain natriuretic levels increased significantly immediately after the test and decreased significantly after 24 hours and returned to the initial levels 24 hours later. It can be concluded that aerobic exercise increasing to the maximum may lead to an increase in cardiac specific troponin I and T and brain natriuretic peptide. However, the increase appears to be temporary and does not cause heart damage.

One of the main components involving in the pathogenesis and prognosis of sepsis and septic shock is natriuretic peptide. Hemodynamic changes in sepsis or septic shock might explain increased plasma levels of these peptides circulations.. The present study aimed to assess the value of brain natriuretic peptide (BNP) in prediction of sepsis state and its related morbidity. We also attempted to determine the best cutoff point of BNP for diagnosis of sepsis state in those with critical illnesses, admitted to the hospital..Patients and In a cross-sectional study on critically ill patients referred to infections unit of Hazrat Rasoul Akram Hospital, the enrolled patients were assigned to one of the sepsis (n = 30) and nonsepsis (n = 30) groups, based on their results of blood culture and clinical manifestations. Plasma level of BNP was measured by immunoassay.. In-hospital mortality was only observed in one patient suffering from sepsis. Hospital length of stay (LOS) was significantly longer in the sepsis group compared with the nonsepsis one (17.47 ± 10.10 days versus 7.93 ± 2.92 days). The plasma BNP level, as a marker, was significantly higher in the sepsis group than the nonsepsis one (786.87 ± 164.11 ng/mL versus 154.57 ± 44.67 ng/mL, P = 0.039). The BNP level was significantly correlated with some baseline variables including respiratory rate (beta = 0.295, P = 0.022) and ESR measurement (beta = 0.296, P = 0.022), but not with other characteristics. Through multivariable linear regression analysis, having other patients’ variables information including demographics and hemodynamic parameters, the BNP level was significantly higher in the sepsis group compared with the nonsepsis one (odds ratio = 1.008, P = 0.046). According to the receiver operating characteristic (ROC) curve analysis, BNP measurement had an acceptable value for discriminating sepsis and nonsepsis states (c = 0.734, 95% CI: 0.605-0.864, P = 0.002). The optimal cutoff point of BNP for discriminating sepsis and nonsepsis states was 170 ng/mL, yielding a sensitivity of 66.7% and a specificity of 60.0%.. Elevated BNP level was associated with a significantly increased risk of sepsis state in critically ill patients..

The precursor of the Brain Natriuretic Peptide (pro-BNP) represents a biological marker whose behavior in stress condition can reveal the beginning of a condition of chronic heart failure in patients at risk. The objective of our work was to evaluate the behavior of pro-BNP after hydrosaline overload on a sample of hypertensive patients. The authors have evaluated the incretory stimulation of brain natriuretic peptide in a group of 13 patients with arterial hypertension. All of the individuals underwent a hydrosaline overload 20% of plasmatic value. Blood samples for pro-BNP determination were obtained from the antebrachial vein at time 0, 2nd hour, 4th hour, 7th hour and 10th hour. The same procedure was applied upon a control group of healthy individuals. The study was repeated after 7 months in 18 hypertensive patients. All of the individuals underwent a hydrosaline overload 25% of plasmatic value. Statistics were calculated with intra-group and intergroup analysis. The results obtained showed an increase in the secretion of pro-BNP which became important after 4 hours from the first examination in the group of hypertnsive patients. No modifications were observed in healthy group. In the second phase of the study, the results become more statistically significant than in the first part of the study. The most interesting result is the difference in secretion of pro-BNP between the hypertension group and control group which occurs earlier in respect to the first part of the study. Moreover, there is an increased production of pro-BNP between the patients with hypertension non-dippers in respect to the dippers. The authors hypothesized that the increase of secretion of pro-BNP during arterial hypertension could be considered as a compensatory phenomenom linked to intolerance toward hydrosaline overload and if so, it can be due to a molecular pathology of the renal tubule and/or to a molecular pathology of the competent cells of cardiac muscle. This phenomenom seems particularly to be evidenced in non-dipping hypertension category of patients in which the cardiovascular risk is very high. Our study contributes to confirm that dynamic tests are more useful tools than static tests in exploring the organ reserve function.

Plasma brain natriuretic peptide (BNP) level increases in proportion to the degree of right ventricular dysfunction in pulmonary hypertension. The aim of this study was to evaluate outcome of treatment and the prognostic value of N-terminal brain natriuretic peptide (N-TproBNP) in patients with pulmonary arterial hypertension (IPAH). This study was a longitudinal trend study. It was conducted in 2011 till 2013 on 20 patients with PAH at Massih Daneshvari hospital, who were treated with intravenous iloprost for 12 weeks. Before, during and after treatment WHO functional class, six minute walking test (6MWT), pulmonary artery pressure (PAP) and right ventricular pressure (RVP) in echocardiography and plasma NT-ProBNP level was measured. Findinges showed that iloprost infusion improved exercise tolerance and functional class and decreased PAP and RVP in patients with IPAH. The level of NT-ProBNP had decreased in 75% of patients and its mean had decreased significantly to 1409 pg/ml (P=0.009). Iloprost is an effective therapy for patients with IPAH. Furthermore, Plasma levels of NT- ProBNP were decreased proportionally to elevate in functional class and 6MWT distance and decrease in PAP and RVP. Measurement of NT-ProBNP is actually advised for the routine assessment and for the clinical decision making of PAH patients.

Recent research establishes the heart as an endocrine gland capable of lowering blood pressure effectively through the secretion of hormones such as atrial natriuretic peptide (ANP). The purpose of this study was to determine the effect of endurance and speed activity on atrial natriuretic peptide (ANP) and blood pressure levels in male athlete students in Yazd. The statistical population for the study was male students at Yazd University, from which 90 male athletes with an average age of 23.42 and at least three years of experience in sports were randomly assigned to one of three endurance, speed, or control groups. The endurance group ran 3200 meters for 12 minutes, while the speed group ran 100 meters four times with rest intervals and at a heart rate of one-third of the target heart rate. Ten minutes before and ten minutes after the activity, blood samples were taken to determine plasma ANP. One session of endurance and speed activity significantly increased plasma ANP compared to the pretest stage (p < 0.05); additionally, there was a significant difference in plasma ANP and systolic and diastolic blood pressure between the group with speed activity and the control group as well as the control group with endurance activity (p < 0.05). The results demonstrated that both endurance and speed activity performed during single session increased plasma ANP and decreased systolic and diastolic blood pressure.