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

Bégué, Céline; Mörner, Stellan; Brito, Dulce; Hengstenberg, Christian; Cleland, John G.F.; Arbustini, Eloisa; Galve, Enrique; Wichter, Thomas; Richter, Anette; Golmard, Jean Louis; Bernard, Maguy; Dubourg, Olivier; Komajda, Michel; Isnard, Richard

doi:10.1136/heartjnl-2019-314826

Cited by 6 publications

(7 citation statements)

References 29 publications

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“…Several strategies to explore biomarkers have been pursued in the last years and provided information about circulating long non-coding RNAs [3][4][5] , microRNAs 6,7 , positron emission tomography (PET) 8 or cardiac MRI parameters 9 as well as circulating natriuretic peptides 10 involved into pathophysiology of HCM. First insights into proteomic data from myocardial hypertrophic tissues have been recently provided and several dysregulated proteins in septal myectomies in patients with HCM were described 11 .…”

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confidence: 99%

Blood-based protein profiling identifies serum protein c-KIT as a novel biomarker for hypertrophic cardiomyopathy

Sonnenschein

Fiedler

Gonzalo-Calvo

et al. 2021

Sci Rep

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Hypertrophic cardiomyopathy (HCM) is one of the most common hereditary heart diseases and can be classified into an obstructive (HOCM) and non-obstructive (HNCM) form. Major characteristics for HCM are the hypertrophy of cardiomyocytes and development of cardiac fibrosis. Patients with HCM have a higher risk for sudden cardiac death compared to a healthy population. In the present study, we investigated the abundancy of selected proteins as potential biomarkers in patients with HCM. We included 60 patients with HCM and 28 healthy controls and quantitatively measured the rate of a set of 92 proteins already known to be associated with cardiometabolic processes via protein screening using the proximity extension assay technology in a subgroup of these patients (20 HCM and 10 healthy controls). After validation of four hits in the whole cohort of patients consisting of 88 individuals (60 HCM patients, 28 healthy controls) we found only one candidate, c-KIT, which was regulated significantly different between HCM patients and healthy controls and thus was chosen for further analyses. c-KIT is a tyrosine-protein kinase acting as receptor for the stem cell factor and activating several pathways essential for cell proliferation and survival, hematopoiesis, gametogenesis and melanogenesis. Serum protein levels of c-KIT were significantly lower in patients with HCM than in healthy controls, even after adjusting for confounding factors age and sex. In addition, c-KIT levels in human cardiac tissue of patients with HOCM were significant higher compared to controls indicating high levels of c-KIT in fibrotic myocardium. Furthermore, c-KIT concentration in serum significantly correlated with left ventricular end-diastolic diameter in HOCM, but not HCM patients. The present data suggest c-KIT as a novel biomarker differentiating between patients with HCM and healthy population and might provide further functional insights into fibrosis-related processes of HOCM.

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confidence: 99%

Blood-based protein profiling identifies serum protein c-KIT as a novel biomarker for hypertrophic cardiomyopathy

Sonnenschein

Fiedler

Gonzalo-Calvo

et al. 2021

Sci Rep

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“…Recently, the predictive value of hematologic biomarkers in patients with HCM has drawn increasing attention. These biomarkers include high-sensitivity C-reactive protein [20], monocyte to HDL-cholesterol ratio [21], red blood cell distribution width [22] and mid-regional proatrial natriuretic peptide [23], all of which are available and novel biomarkers in predicting clinical prognosis in patients with HCM.…”

Section: Discussionmentioning

confidence: 99%

“…NT-proBNP is released when cardiac myocytes are exposed to hemodynamic stress [8] and has a strong association with left ventricular hypertrophy and insufficiency [9,24]. Previous studies have revealed that elevated plasma concentration of NT-proBNP in patients with HCM and found that there was a correlation with more left ventricular outflow tract (LVOT) obstruction, worsening symptoms, and reduced exercise tolerance [23,25]. Although the correlation of elevated NT-proBNP value with more risk of adverse clinical events in patients with HCM has been demonstrated by previous studies [11,25,26], while the present study showed differences in the predictive values of NT-proBNP in patients with HCM, which are due to the highly heterogeneous clinical pattern and the differences in enrolled populations.…”

Section: Discussionmentioning

confidence: 99%

N-terminal pro-brain natriuretic peptide and adverse outcomes in Chinese patients with hypertrophic cardiomyopathy

Zhang

Qin

et al. 2022

Bioscience Reports

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Background: Although numerous studies have suggested that elevated N-terminal pro-brain natriuretic peptide (NT-proBNP) is positively correlated with cardiovascular events, especially the heart failure and heart failure-related death (HFRD), evidence of the association between NT-proBNP and the adverse outcomes of hypertrophic cardiomyopathy (HCM) is still relatively limited. The present study was performed to evaluate the relationship between NT-proBNP and outcomes in patients with HCM. Methods: Observational cohort methodology was used in this study, and a total of 227 patients were included. And the patients were followed for 44.97 ± 16.37 months. Patients were categorized into three groups according to these NT-proBNP tertiles: first tertile (≤ 910 pg/mL, n=68), second tertile (913-2141 pg/mL, n=68), and third tertile (≥ 2151 pg/mL, n=69). The adverse outcomes of this study were all-cause death (ACD) and cardiac death (CD). Results: According to the risk category of NT-proBNP, the incidences of ACD (P=0.005) and CD (P=0.032) among the three groups showed significant differences. Multivariate Cox regression analysis suggested that the ACD and CD in the third tertile have 7.022 folds (hazard risk [HR] =7.022 [95% confidence interval [CI]: 1.397-35.282], P=0.018) and 7.129 folds ([HR] =7.129 [95% [CI]: 1.329-38.237], P=0.022) increased risks as compared with those in the first tertile. Kaplan-Meier survival analyses showed that the cumulative risks of ACD and CD in patients with HCM tended to increase. Conclusion: The present study indicated NT-proBNP was a novel biomarker suitable for predicting adverse prognosis in patients with HCM, which may be used for early recognition and risk stratification.

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“…Compared with BNP, NT-proBNP is more stable on the merit of its longer half-life ( 23 ). Some studies reported that NT-proBNP was associated with cardiac fibrosis, deterioration of cardiac function, and prognosis in HCM patients ( 26 – 29 ). According to the 2016 ESC guideline ( 30 ), the NT-proBNP cutoff value is 125 pg/mL, whereas the 2017 AHA criteria suggested using a threshold of 800 pg/mL ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

Left ventricular strain patterns and their relationships with cardiac biomarkers in hypertrophic cardiomyopathy patients with preserved left ventricular ejection fraction

Zhang

Wan

et al. 2022

Front. Cardiovasc. Med.

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AimsThis study aims to assess left ventricular (LV) function in hypertrophic cardiomyopathy (HCM) patients with preserved left ventricular ejection fraction (LVEF) by LV strain patterns based on cardiac magnetic resonance feature tracking (CMR-FT) and to explore the relationships between LV strain patterns and cardiac biomarkers in these patients, such as cardiac troponin (cTnT) and N-terminal prohormone of the brain natriuretic peptide (NT-proBNP).MethodsA total of 64 HCM patients with preserved LVEF and 33 healthy people were included in this study. All subjects underwent contrast-enhanced CMR, and all patients took blood tests for cTnT and NT-proBNP during hospitalization.ResultsDespite the absence of a significant difference in LVEF between HCM patients and healthy controls, almost all global and segmental strains in radial, circumferential, and longitudinal directions in the HCM group deteriorated significantly as compared to controls (p < 0.05). Moreover, some global and segmental strains correlated significantly with NT-proBNP and cTnT in HCM patients, and the best correlations were global radial strain (GRS) (r = −0.553, p < 0.001) and mid-ventricular radial strain (MRS) (r = −0.582, p < 0.001), respectively, with a moderate correlation. The receiver operating characteristic (ROC) results showed that among the LV deformation parameters, GRS [area under the curve (AUC), 0.76; sensitivity, 0.49; specificity, 1.00], MRS (AUC, 0.81; sensitivity, 0.77; specificity, 0.79) demonstrated greater diagnostic accuracy to predict elevated NT-proBNP, and abnormal cTnT, respectively. Their cut-off values were 21.17 and 20.94%, respectively. Finally, all global strains demonstrated moderate, good, and excellent intra- and inter-observer reproducibility.ConclusionLV strain patterns can be used to assess the subclinical cardiac function of HCM patients on the merit of being more sensitive than LVEF. In addition, LV strain patterns can detect serious HCM patients and may be helpful to non-invasively predict elevated NT-proBNP and cTnT.

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

Cited by 6 publications

References 29 publications

Blood-based protein profiling identifies serum protein c-KIT as a novel biomarker for hypertrophic cardiomyopathy

Blood-based protein profiling identifies serum protein c-KIT as a novel biomarker for hypertrophic cardiomyopathy

N-terminal pro-brain natriuretic peptide and adverse outcomes in Chinese patients with hypertrophic cardiomyopathy

Left ventricular strain patterns and their relationships with cardiac biomarkers in hypertrophic cardiomyopathy patients with preserved left ventricular ejection fraction

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