Comparison of Midregional Pro-Atrial and B-Type Natriuretic Peptides in Chronic Heart Failure

Abstract

Despite similarities in influencing factors and detection of reduced LVEF, MR-proANP outperformed BNP and NT-proBNP in the prediction of death. A new assay technology and the high biological stability of MR-proANP are potential explanations for these findings.

Biomarkers and Peak Oxygen Uptake in Patients with Chronic Lung Disease

“…In patients with cardiac disease, several novel biomarkers, such as midregional pro-A-type natriuretic peptide (MR-proANP) [10,11,12], midregional proadrenomedullin (MR-proADM) [13], C-terminal proendothelin-1 (CT-proET-1) [14], and C-terminal provasopressin (CT-proAVP, copeptin) [15,16], which are promising markers of pathophysiological processes, have been shown to be as accurate or even more accurate in predicting prognosis than the established B-type natriuretic peptides. MR-proANP is the stable midregional part of the ANP precursor peptide and is thereby considered to be a marker of left atrial stretch [17].…”

“…MR-proANP is the stable midregional part of the ANP precursor peptide and is thereby considered to be a marker of left atrial stretch [17]. In patients with chronic heart failure (HF), MR-proANP is a marker of left-ventricular ejection fraction (LVEF) and mortality [11,12], and in postmyocardial infarction (MI) patients, MR-proANP is a marker of outcome too [10]. MR-proADM is the midregional part of the precursor peptide of adrenomedullin, a peptide with vasorelaxing and natriuretic properties [18].…”

Molecular Biomarkers for Diagnostics, Risk Stratification and Prediction of Chronic Heart Failure

“…Ввиду того, что биологические триггеры синтеза натрий-уретических пептидов при-сутствуют при обоих типах СН, BNP и NT-proBNP, имеют высокую диагностическую точность как при СН со сниженной, так и с сохранённой фракцией выброса (ФВ) левого желудочка (ЛЖ) [6]. В ходе мно-гочисленных исследований были определены так называемые "пороговые значения" натрий-уретиче-ских гормонов для диагностики СН [6,[12][13][14], пред-ставленные в таблице 2. ривается как менее значимый маркер СН благодаря своему быстрому периоду полувыведения, его стабиль-ный фрагмент MR-proANP имеет более устойчивую концентрацию и может использоваться в качестве на дежного биомаркера [16]. Согласно результатам исследования PRIDE, MRproANP являлся независимым предиктором диагноза СН в модели, включавшей NT-proBNP (отношение шансов (ОШ) 4,34, 95% доверительный интервал (ДИ) 2,11-8,92, p<0,001), и позволял корректно классифици-ровать как ложноотрицательные, так и ложноположи-тельные результаты предварительной диа гностики СН [17,20].…”

Use of ivabradine and atorvastatin in emergent orthopedic lower limb surgery and computed tomography coronary plaque imaging and novel biomarkers of cardiovascular stress and lipid metabolism for the study and prevention of perioperative myocardial infarction: study protocol for a randomized controlled trial

“…In patients with stable coronary artery disease and preserved left ventricular ejection fraction, elevated levels of these novel biomarkers can help identify patients who are at higher risk of cardiovascular death and heart failure [65]. Higher levels of these three biomarkers have been associated with an increased risk of death and/or heart failure events in patients with established heart failure [70–72]. …”

“…The mid-regional (MR) fragments of proANP and proADM are also more stable in vivo and ex vivo than the amino- or carboxy-terminal part of the prohormone, thereby minimizing the risk of underestimation of levels as a result of early degradation of crucial epitopes at the extreme ends of the molecule [73]. In studies of patients with established heart failure, elevated levels of MR-proANP, MR-proADM and carboxy-terminal fragment of ET-1 (CT-proET-1) have been shown to be associated with mortality independently of clinical variables, and the biomarkers have displayed prognostic and discriminatory value that has compared favorably with BNP and/or NT-proBNP in the heart failure population [70–72]. …”