Mid-regional proatrial natriuretic peptide for predicting prognosis in hypertrophic cardiomyopathy

Bégué, C. et al. (2020) Mid-regional proatrial natriuretic peptide for predicting prognosis in hypertrophic cardiomyopathy. Heart, 106(3), pp. 196-202. (doi: 10.1136/heartjnl-2019-314826) (PMID:31350276)

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Abstract

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.

Item Type:Articles
Additional Information:This work was supported by Fondation Leducq, Ligue contre la Cardiomyopathie, and Fédération Française de Cardiologie.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Cleland, Professor John
Authors: Bégué, C., Mörner, S., Brito, D., Hengstenberg, C., Cleland, J. G.F., Arbustini, E., Galve, E., Wichter, T., Richter, A., Golmard, J.-L., Bernard, M., Dubourg, O., Komajda, M., Charron, P., and Isnard, R.
Subjects:R Medicine > R Medicine (General)
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:Heart
Publisher:BMJ Publishing Group
ISSN:1355-6037
ISSN (Online):1468-201X
Published Online:26 July 2019
Copyright Holders:Copyright © 2019 The Authors
First Published:First published in Heart 106(3): 196-202
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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