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Mid-regional proatrial natriuretic peptide for predicting prognosis in hypertrophic cardiomyopathy
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
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2020 (English)In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 106, no 3, p. 196-202Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
BMJ PUBLISHING GROUP , 2020. Vol. 106, no 3, p. 196-202
Keywords [en]
natriuretic peptide, MR-proANP, NT-proBNP, hypertrophic cardiomyopathy
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:umu:diva-168136DOI: 10.1136/heartjnl-2019-314826ISI: 000507910100009PubMedID: 31350276Scopus ID: 2-s2.0-85077728839OAI: oai:DiVA.org:umu-168136DiVA, id: diva2:1395124
Available from: 2020-02-21 Created: 2020-02-21 Last updated: 2023-03-23Bibliographically approved

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Mörner, Stellan

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