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Mid-regional proatr...
Mid-regional proatrial natriuretic peptide for predicting prognosis in hypertrophic cardiomyopathy
- Article/chapterEnglish2020
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2019-07-26
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BMJ PUBLISHING GROUP,2020
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LIBRIS-ID:oai:DiVA.org:umu-168136
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https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-168136URI
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https://doi.org/10.1136/heartjnl-2019-314826DOI
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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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.
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Mörner, StellanUmeå universitet,Kardiologi(Swepub:umu)stmo0005
(author)
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Brito, Dulce
(author)
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Hengstenberg, Christian
(author)
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Cleland, John G. F.
(author)
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Arbustini, Eloisa
(author)
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Galve, Enrique
(author)
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Wichter, Thomas
(author)
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Richter, Anette
(author)
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Golmard, Jean-Louis
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Bernard, Maguy
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Dubourg, Olivier
(author)
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Komajda, Michel
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Charron, Philippe
(author)
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Isnard, Richard
(author)
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Umeå universitetKardiologi
(creator_code:org_t)
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In:Heart: BMJ PUBLISHING GROUP106:3, s. 196-2021355-60371468-201X
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Heart
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Begue, Celine
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Mörner, Stellan
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Brito, Dulce
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Hengstenberg, Ch ...
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Cleland, John G. ...
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Arbustini, Elois ...
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Galve, Enrique
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Wichter, Thomas
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Richter, Anette
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Golmard, Jean-Lo ...
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Bernard, Maguy
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Dubourg, Olivier
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Komajda, Michel
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Charron, Philipp ...
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Isnard, Richard
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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Heart
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Umeå University