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Mid-regional proatrial natriuretic peptide for predicting prognosis in hypertrophic cardiomyopathy
- Begue, Celine (author)
-
- Mörner, Stellan (author)
- Umeå universitet,Kardiologi
- Brito, Dulce (author)
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- Hengstenberg, Christian (author)
- Cleland, John G. F. (author)
- Arbustini, Eloisa (author)
- Galve, Enrique (author)
- Wichter, Thomas (author)
- Richter, Anette (author)
- Golmard, Jean-Louis (author)
- Bernard, Maguy (author)
- Dubourg, Olivier (author)
- Komajda, Michel (author)
- Charron, Philippe (author)
- Isnard, Richard (author)
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- (creator_code:org_t)
- 2019-07-26
- 2020
- English.
- In: Heart. - : BMJ PUBLISHING GROUP. - 1355-6037 .- 1468-201X. ; 106:3, s. 196-202
- Journal article (peer-reviewed)
Abstract
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- Objectives N-terminal probrain natriuretic peptide (NT-proBNP) predicts mortality and the development of heart failure in hypertrophic cardiomyopathy (HCM). Mid-regional proatrial natriuretic peptide (MR-proANP) is a stable by-product of production of atrial natriuretic peptide. We sought to compare the prognostic value of MR-proANP and NT-proBNP in HCM. Methods We prospectively enrolled a cohort of patients with HCM from different European centres and followed them. All patients had clinical, ECG and echocardiographic evaluation and measurement of MR-proANP and NT-proBNP at inclusion. Results Of 357 patients enrolled, the median age was 52 (IQR: 36-65) years. MR-proANP and NT-proBNP were both independently associated with age, weight, New York Heart Association (NYHA) class, left ventricular ejection fraction (LVEF), wall thickness and left atrial dimension. During a median follow-up of 23 months, 32 patients had a primary end point defined as death (n=6), heart transplantation (n=8), left ventricular assist device implantation (n=1) or heart failure hospitalisation (n=17). Both NT-proBNP and MR-proANP (p<10(-4)) were strongly associated with the primary endpoint, and the areas under the receiver operating characteristic (ROC) curves for both peptides were not significantly different. However, in a multiple stepwise regression analysis, the best model for predicting outcome was NYHA 1-2 vs 3-4 (HR=0.35, 95% CI 0.16 to 0.77, p<0.01), LVEF (HR=0.96, 95% CI 0.94 to 0.98, p=0.0005) and MR-proANP (HR=3.77, 95% CI 2.01 to 7.08, p<0.0001). Conclusions MR-proANP emerges as a valuable biomarker for the prediction of death and heart failure related events in patients with HCM.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- natriuretic peptide
- MR-proANP
- NT-proBNP
- hypertrophic cardiomyopathy
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- ref (subject category)
- art (subject category)
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- Mörner, Stellan
- Brito, Dulce
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- Galve, Enrique
- Wichter, Thomas
- Richter, Anette
- Golmard, Jean-Lo ...
- Bernard, Maguy
- Dubourg, Olivier
- Komajda, Michel
- Charron, Philipp ...
- Isnard, Richard
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