Relation between serum N-terminal pro-brain natriuretic peptide and prognosis in patients with hypertrophic cardiomyopathy

Coats, Caroline; Gallagher, Matthew J.; Foley, Michael R.; O’Mahony, Constantinos; Critoph, Christopher; Gimeno, Juan R.; Dawnay, Anne; McKenna, William J.; Elliott, Perry

doi:10.1093/eurheartj/eht070

Cited by 96 publications

(60 citation statements)

References 31 publications

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“…BNP or NT-proBNP was associated with all-cause mortality and a subsequent need for septal reduction therapy or HF-related death and transplantation, respectively (11,22). We did not show the survival analysis regarding all-cause mortality because there were only three death events (mortality rate of 2.17 per 100 person-year, which was similar to their study).…”

Section: Prognostic Markers Of Hcmmentioning

confidence: 54%

Interrelationship between the Myocardial Mass, Fibrosis, BNP, and Clinical Outcomes in Hypertrophic Cardiomyopathy

et al. 2016

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Objective Increased left ventricular mass (LVM) and LV fibrosis mass (LVFM) are characteristics of hypertrophic cardiomyopathy (HCM). Additionally, a substantial increase in the plasma B-type natriuretic peptide (BNP) level is observed. Therefore, we investigated the interrelationship and clinical significances of these parameters in a HCM cohort that underwent cardiac MRI (CMR). Methods Patients with HCM (n=109) receiving regular outpatient treatment underwent CMR and follow-up through 2015 from CMR examinations. The clinical outcome measures were all-cause mortality, admission for worsening heart failure, and ventricular tachycardia/fibrillation. Results The baseline body mass index (BMI), LV outflow tract (LVOT) obstruction, New York Heart Association (NYHA) class, and increased left atrial dimension (LAD) index were associated with the plasma BNP level. In the CMR analysis, LVM and LVFM indices significantly correlated with the BNP level (r=0.422 and 0.368, respectively), which were independent determinants according to a multivariate analysis (p=0.009 and 0.023, respectively). A Kaplan-Meier analysis during a median follow-up of 19.4 months showed that the baseline LVM or LVFM index was not associated with the clinical outcomes. However, the baseline BNP level was significantly associated with them (p<0.001). In addition, a multivariate Cox proportional hazard analysis showed that plasma BNP was an independent predictor for the clinical outcomes after adjusting for age, sex, LVM, and LVFM. Conclusion The LVM and LVFM are determinants of the BNP level independent of the BMI, LVOT obstruction, LAD, and NYHA class in patients with HCM. However, plasma BNP may be a more sensitive integrated-marker for the clinical outcomes than LVM or LVFM.

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Section: Prognostic Markers Of Hcmmentioning

confidence: 54%

Interrelationship between the Myocardial Mass, Fibrosis, BNP, and Clinical Outcomes in Hypertrophic Cardiomyopathy

et al. 2016

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“…This is in line with the higher proportion of LGE in patients with ASHCM. It is well established that women and older age were associated with higher NT-proBNP concentration levels [34]. This study was the first to compare the concentration of NT-proBNP between age- and gender-matched ApHCM and ASHCM patients.…”

Section: Discussionmentioning

confidence: 93%

“…This study was the first to compare the concentration of NT-proBNP between age- and gender-matched ApHCM and ASHCM patients. NT-proBNP was independently associated with cardiac death in HCM patients [34,35], which could explain the higher rate of cardiovascular death in patients with ASHCM.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Long-Term Outcome between Apical and Asymmetric Septal Hypertrophic Cardiomyopathy

Fan²,

Lu³

et al. 2016

Cardiology

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Objectives: As reported, diagnostic age, gender and presence of outflow tract obstruction have an impact on prognosis in patients with hypertrophic cardiomyopathy. The aim of this study was to compare the long-term outcome between apical hypertrophic cardiomyopathy (ApHCM) and asymmetric septal hypertrophic cardiomyopathy (ASHCM) after the exclusion of these factors. Methods: A total of 540 patients (270 with ApHCM and 270 with ASHCM) identified in a consecutive single-center cohort were retrospectively studied. The two groups were matched by diagnostic age, gender and the presence of outflow tract obstruction. Clinical characteristics and long-term outcomes were compared. Results: The mean follow-up duration in ASHCM and ApHCM were 6.6 ± 5.5 and 7.6 ± 4.1 years, respectively. During follow-up, 16 patients experienced cardiovascular death in the ASHCM group, while 2 patients experienced cardiovascular death in the ApHCM group (6.3 vs. 0.7%, p < 0.01). Cardiovascular morbidity in the ASHCM and ApHCM groups were 39.9 and 18.5% (p < 0.01). In the multivariate Cox regression analysis late gadolinium enhancement (LGE; HR 4.81, 95% CI 1.28-78.0, p = 0.03) and unexplained syncope (HR 9.68, 95% CI 1.9-17.2, p < 0.01) were independent predictors for cardiovascular mortality. Unexplained syncope was independently associated with a higher risk for sudden cardiac death (HR 4.3, 95% CI 1.2-15.3, p = 0.02). Conclusions: After eliminating the interference of diagnostic age, gender and outflow tract obstruction, ASHCM represented a worse prognosis with a higher incidence of cardiovascular mortality and morbidity than ApHCM. LGE was a strong predictor for cardiovascular death.

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“…Late gadolinium enhancement on cardiovascular MRI5–7 and elevated N-terminal pro-brain natriuretic peptide level8 have been evaluated as early biomarkers of poor outcomes in HCM. Diagnostic two-dimensional echocardiography is performed in all patients with HCM.…”

Section: Introductionmentioning

confidence: 99%

Global longitudinal strain is associated with heart failure outcomes in hypertrophic cardiomyopathy

Réant

Mirabel

Lloyd

et al. 2016

Heart

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Relation between serum N-terminal pro-brain natriuretic peptide and prognosis in patients with hypertrophic cardiomyopathy

Abstract: In patients with HCM, elevated NT-proBNP concentration is a strong predictor of overall prognosis, particularly HF-related death and transplantation.

Cited by 96 publications

References 31 publications

Interrelationship between the Myocardial Mass, Fibrosis, BNP, and Clinical Outcomes in Hypertrophic Cardiomyopathy

Interrelationship between the Myocardial Mass, Fibrosis, BNP, and Clinical Outcomes in Hypertrophic Cardiomyopathy

Comparison of Long-Term Outcome between Apical and Asymmetric Septal Hypertrophic Cardiomyopathy

Global longitudinal strain is associated with heart failure outcomes in hypertrophic cardiomyopathy

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