1. Mid-regional proatrial natriuretic peptide for predicting prognosis in hypertrophic cardiomyopathy
- Author
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Stellan Mörner, Christian Hengstenberg, Anette Richter, Eloisa Arbustini, Céline Bégué, Enrique Galve, Dulce Brito, Olivier Dubourg, Philippe Charron, Richard Isnard, Thomas Wichter, John G.F. Cleland, Maguy Bernard, Michel Komajda, Jean Louis Golmard, Service de Cardiologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Umeå University, Medizinische Universität Wien = Medical University of Vienna, Imperial College London, University of Glasgow, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Osnabrück University, Département de Biostatistique, Santé Publique et Information Médicale [CHU Pitié-Salpêtrière] (BIOSPIM ), Sorbonne Université (SU), Service de Biochimie Métabolique [CHU Pitié-Salpêtrière], Hôpital Ambroise Paré [AP-HP], Centre hospitalier Saint-Joseph [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), and Service de Génétique Cytogénétique et Embryologie [CHU Pitié-Salpêtrière]
- Subjects
Male ,Time Factors ,[SDV]Life Sciences [q-bio] ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,0302 clinical medicine ,Atrial natriuretic peptide ,Risk Factors ,Cause of Death ,Natriuretic Peptide, Brain ,Natriuretic peptide ,Medicine ,Prospective Studies ,030212 general & internal medicine ,Heart transplantation ,Ejection fraction ,Hypertrophic cardiomyopathy ,Middle Aged ,Prognosis ,Europe ,Cohort ,Disease Progression ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,Atrial Natriuretic Factor ,Adult ,medicine.medical_specialty ,medicine.drug_class ,MR-proANP ,03 medical and health sciences ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Predictive Value of Tests ,Internal medicine ,Humans ,cardiovascular diseases ,Aged ,Heart Failure ,natriuretic peptide ,business.industry ,Reproducibility of Results ,Cardiomyopathy, Hypertrophic ,hypertrophic cardiomyopathy ,medicine.disease ,R1 ,Peptide Fragments ,NT-proBNP ,Ventricular assist device ,Heart failure ,business ,Biomarkers - Abstract
ObjectivesN-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.MethodsWe 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.ResultsOf 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–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, pConclusionsMR-proANP emerges as a valuable biomarker for the prediction of death and heart failure related events in patients with HCM.
- Published
- 2020
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