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Clinical Chemistry 42: 1627-1633, 1996;
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Clinical Chemistry, Vol 42, 1627-1633, Copyright © 1996 by American Association for Clinical Chemistry

Analytical performance and clinical usefulness of a commercially available IRMA kit for measuring atrial natriuretic peptide in patients with heart failure

A Clerico, G Iervasi, MG Del Chicca, S Maffei, S Berti, L Sabatino, S Turchi, F Cazzuola, C Manfredi and A Biagini
Laboratory of Cardiovascular Endocrinology, CNR Institute of Clinical Physiology, Pisa, Italy. clerico@nsifc.ifc.pi.cnr.it

We evaluated the analytical characteristics and clinical usefulness of a commercially available IRMA kit for measuring plasma concentrations of atrial natriuretic peptide (ANP) in healthy subjects and in patients with heart failure. The method uses two monoclonal antibodies prepared against sterically remote epitopes of the ANP molecule; the first antibody is coated on the solid-phase beads, and the second is radiolabeled with 125I. Fifty-nine healthy subjects and 77 patients with heart failure were studied. After subjects had rested 20 min in a recumbent position, blood samples were collected from a brachial vein into ice-chilled disposable polypropylene tubes containing aprotinin and EDTA. Plasma samples were immediately separated by centrifugation and stored at -20 degrees C until assay. The working range (CV <15%) was 10-2000 ng/L. The detection limit (2.13 +/- 0.91 ng/L) was similar to those reported for other IRMAs but was much better than those of RIAs. For healthy subjects, the results of this method (18.0 +/- 10.6 ng/L, range 4.7-63 ng/L, median 16.7 ng/L, n = 59) were similar to those generally reported for the most accurate methods, i.e., those using preliminary extraction and chromatographic purification of plasma samples. Measured plasma ANP was significantly associated with the severity of clinical symptoms, i.e., NYHA class (ANOVA, P <0.0001), and with the left ventricular ejection fraction (n = 62, r = 0.618, P <0.0001). Patients with severe heart failure showed greatly increased values (NYHA III-IV: 257.4 +/- 196.6 ng/L, n = 23).


The following articles in journals at HighWire Press have cited this article:


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Diagnostic Accuracy and Prognostic Relevance of the Measurement of Cardiac Natriuretic Peptides: A Review
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C. Prontera, M. Emdin, G. C. Zucchelli, A. Ripoli, C. Passino, and A. Clerico
Natriuretic Peptides (NPs): Automated Electrochemiluminescent Immunoassay for N-Terminal pro-BNP Compared with IRMAs for ANP and BNP in Heart Failure Patients and Healthy Individuals
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M. G. Andreassi, S. Del Ry, C. Palmieri, A. Clerico, A. Biagini, and D. Giannessi
Up-regulation of 'clearance' receptors in patients with chronic heart failure: a possible explanation for the resistance to biological effects of cardiac natriuretic hormones
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A. Clerico, S. Del Ry, and D. Giannessi
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Y. Numata, K. Dohi, A. Furukawa, S. Kikuoka, H. Asada, T. Fukunaga, Y. Taniguchi, K. Sasakura, T. Tsuji, K. Inouye, et al.
Immunoradiometric assay for the N-terminal fragment of proatrial natriuretic peptidein human plasma
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 Am. J. Physiol. Endocrinol. Metab.Home page
A. Pilo, G. Iervasi, A. Clerico, F. Vitek, S. Berti, C. Palmieri, A. Biagini, and L. Donato
Circulatory model in metabolic studies of rapidly renewed hormones: application to ANP kinetics
Am J Physiol Endocrinol Metab, March 1, 1998; 274(3): E560 - E572.
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G. Iervasi, A. Clerico, A. Pilo, F. Vitek, S. Berti, C. Palmieri, M. Ravani, L. Sabatino, C. Manfredi, M. G. Del Chicca, et al.
Evidence That Atrial Natriuretic Peptide Tissue Extraction Is Not Changed by Large Increases in Its Plasma Levels Induced by Pacing in Humans
J. Clin. Endocrinol. Metab., March 1, 1997; 82(3): 884 - 888.
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