Circulating biomarkers of hypertrophy and fibrosis in patients with hypertrophic cardiomyopathy assessed by cardiac magnetic resonance

Gawor, Monika; Śpiewak, Mateusz; Kubik, Agata; Wróbel, Aleksandra; Lutyńska, Anna; Marczak, Magdalena; Grzybowski, Jacek

doi:10.1080/1354750x.2018.1474261

Cited by 26 publications

(30 citation statements)

References 30 publications

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“…Left ventricular hypertrophy, LAE or both were associated with significantly increased NT‐proBNP concentrations in cats with HCM in our study. Similar findings have been described previously in cats, 12,14,15 dogs, 34 and people 42‐44 . The POCT had similar SE and SP as did the ELISA for diagnosing HCM in cats, which is in agreement with previous studies in which SE of the tests ranged between 71%‐92% and SP between 94%‐100% for detecting cardiac disease 12,14,15 .…”

Section: Discussionsupporting

confidence: 90%

Effect of feline characteristics on plasma N‐terminal‐prohormone B‐type natriuretic peptide concentration and comparison of a point‐of‐care test and an ELISA test

Hanås

Holst

Höglund

et al. 2020

Veterinary Internal Medicne

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Background: Increased plasma concentration of N-terminal-prohormone B-type natriuretic peptide (NT-proBNP) can be detected in cats with cardiac disease. Potential effects of feline characteristics on NT-proBNP concentration may influence clinical usefulness. Objectives: To evaluate potential effects of feline characteristics on NT-proBNP plasma concentration and to compare NT-proBNP plasma concentrations in healthy cats with results in hypertrophic cardiomyopathy (HCM) cats with or without left atrial enlargement (LAE) using an ELISA and a point-of-care test (POCT), and assess if POCT results reflect ELISA results. Animals: One hundred healthy cats of 3 breeds and 39 HCM cats were included.Methods: Diseases other than HCM were excluded by physical examination, blood pressure measurement, echocardiography, hematology, and serum biochemistry.Results: Higher NT-proBNP concentrations were found in males than in females in healthy (P = .005) and in HCM cats (P = .0021), but breed had no effect on NT-proBNP concentrations. Using ≥100 pmol/L as a cutoff for abnormal samples, ELISA and POCT had similar sensitivity (SE; 72 and 74%) and specificity (SP; 97 and 98%) for detecting cats with HCM, cats with HCM and LAE (SE, both 100%; SP, 97 versus 98%), and cats with HCM without LAE (SE, both 69%; SP, 97 versus 98%), respectively, when compared to healthy cats. Conclusions and Clinical Importance:Breed had no effect on plasma NT-proBNP concentrations, but higher concentrations were found in male than in female cats.Abbreviations: 2D, 2-dimension; ALT, alanine aminotransferase; Ao, aorta; BCS, body condition score; BNP, B-type natriuretic peptide; BW, body weight; CHF, congestive heart failure; CV, coefficient of variation; DSH, Domestic Shorthair; FS, fractional shortening; HCM, hypertrophic cardiomyopathy; HDO, high-definition oscillometric device; HR, heart rate auscultation; IQR, interquartile range; IVSd, interventricular septum diastole; IVSd inc% , percentage increase interventricular septal diameter in end diastole; LA, left atrium; LA/Ao, left atrial-to-aortic root diameter ratio; LV, left ventricle; LVFWd, left ventricular free wall diameter in end diastole; LVFWdinc%, percentage increase of left ventricular free wall diameter in end diastole; LVIDd, left ventricular internal diameter in end diastole; LVIDdinc%, percentage increase of left ventricular internal diameter in end diastole; LVIDs, left ventricular internal diameter in systole; NF, Norwegian Forest; NP, natriuretic peptide; NT-proBNP, N-terminal-prohormone-B-type natriuretic peptide; proBNP, prohormone-BNP; POCT, point-of-care test; ROC, receiver operator characteristic curve; SAM, systolic anterior motion; SBP, systolic blood pressure; SE, sensitivity; SP, specificity; T4, thyroxine.

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Section: Discussionsupporting

confidence: 90%

Effect of feline characteristics on plasma N‐terminal‐prohormone B‐type natriuretic peptide concentration and comparison of a point‐of‐care test and an ELISA test

Hanås

Holst

Höglund

et al. 2020

Veterinary Internal Medicne

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“…One study demonstrated that only the hs-cTnI was an independent indicator of the presence of LGE [14]. On the contrary, another study revealed that Nt-proBNP, not hs-cTnI, was strongly correlated with the amount of LGE [15]. And the present study not only showed that the serum levels of Nt-proBNP were correlated with the LGE% in multivariate analyses, but also was useful for the detection of myocardial brosis.…”

Section: Discussionsupporting

confidence: 41%

“…The above differences in the relationship between the circulating biomarkers and the LGE% may be due to the different study populations and methods of quantifying LGE with CMR. Speci cally, in line with the study by Kawasaki et al [16] our study excluded patients with LVEF < 50%, whereas the other two studies did not [14,15]. Additionally, previous studies usually used the visual scoring or semiquantitative scoring method [14,27], and the 2SD thresholding method was used in Kawasaki's study [16].…”

Section: Discussionmentioning

confidence: 65%

“…It is now well established that the serum Nt-proBNP and hs-cTnI levels were elevated in LGE-positive patients than in LGE-negative patients [14,16,25,26]. However, few data are available regarding the two biomarkers' utility for detecting LGE in HCM patients, and the prognostic value of both biomarkers in predicting brosis was inconsistent [14][15][16]. One study demonstrated that only the hs-cTnI was an independent indicator of the presence of LGE [14].…”

Section: Discussionmentioning

confidence: 99%

“…Although some modest sized studies have been showed a correlation of brosis with hs-cTnI and Nt-proBNP [14][15][16], the prognostic value of both biomarkers in predicting brosis in HCM patients was inconsistent and, not systematically evaluated in HCM patients with preserved ejection fraction (EF).…”

mentioning

confidence: 99%

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Elevated level of N-terminal pro B-type natriuretic peptide is associated with myocardial fibrosis in hypertrophic cardiomyopathy patients with preserved ejection fraction

Shi

Liu

et al. 2020

Preprint

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Background: Myocardial fibrosis assessed by late gadolinium enhancement (LGE) on cardiovascular magnetic resonance (CMR) has been reported to be significantly correlated with cardiovascular outcomes in hypertrophic cardiomyopathy (HCM) patients. However, data regarding non-invasive markers for detecting myocardial fibrosis were inconsistent and, not systematically evaluated in HCM patients with preserved ejection fraction (EF).Methods: In this study, 86 HCM patients with preserved EF and 33 controls were enrolled. The left ventricular function, end-diastolic maximum wall thickness (MWT), global systolic strains and extent of LGE (% LGE) were assessed. The biochemical indices were also recorded before the CMR examination.Results: Serum high-sensitivity cardiac troponin I (hs-cTnI) and N-terminal pro b-type natriuretic peptide (Nt-proBNP) levels were elevated in LGE-positive patients compared with LGE-negative patients (p < 0.05 for all). The LGE-positive patients had lower global longitudinal (GLS) and circumferential (GCS) strains than the LGE-negative group and the healthy controls (p < 0.05 for all). The LGE% was independently associated with the Nt-proBNP levels (standardized β = 0.627, p < 0.001), beta-blocker treatment (standardized β = -0.372, p = 0.01), MWT (standardized β = 0.481, p = 0.001) and GCS (standardized β = 0.406, p = 0.013). In the receiver operating characteristic (ROC) curve analysis, the combined parameters of Nt-proBNP ≥ 108 pg/mL and MWT ≥ 17.3 mm had good diagnostic performance for LGE, with a specificity of 81.3% and sensitivity of 70.0%.Conclusions: This study suggests that Nt-proBNP may be a potential biomarker associated with LGE% and, combined with MWT, was useful in detecting myocardial fibrosis in HCM patients with preserved EF. Additionally, LV GCS may be a more sensitive indicator for reflecting the presence of myocardial fibrosis than GLS.

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Growth differentiation factor 15 as mortality predictor in heart failure patients with non‐reduced ejection fraction

et al. 2020

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Aims The prognostic value of biomarkers in patients with heart failure (HF) and mid-range (HFmrEF) or preserved ejection fraction (HFpEF) has not been widely addressed. The aim of this study was to assess whether the prognostic value of growth differentiation factor 15 (GDF-15) is superior to that of N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with HFmrEF or HFpEF. Methods and results Heart failure patients with either HFpEF or HFmrEF were included in the study. During their first visit to the HF unit, serum samples were obtained and stored for later assessment of GDF-15 and NT-proBNP concentrations. Patients were followed up by the HF unit. The main endpoint was all-cause mortality. A total of 311 patients, 90 (29%) HFmrEF and 221 (71%) HFpEF, were included. Mean age was 72 ± 13 years, and 136 (44%) were women. No differences were found in GDF-15 or NT-proBNP concentrations between both HF groups. During a median follow-up of 15 months (Q1-Q3: 9-30 months), 98 patients (32%) died, most (71%) of cardiovascular causes. Patients who died had higher median concentrations of GDF-15 (4085 vs. 2270 ng/L, P < 0.0001) and NT-proBNP (1984 vs. 1095 ng/L, P < 0.0001). A Cox multivariable model identified New York Heart Association Functional Class III (P = 0.04), systolic blood pressure (P = 0.01), left atrial diameter (P = 0.03), age >65 years (P < 0.0001), and GDF-15 concentrations (P = 0.01) but not NT-proBNP as independent predictors of allcause mortality. The area under the curve was 0.797 for the basic model including NT-proBNP, and the area under the curve comparing the overall model was 0.819, P = 0.016 (DeLong's test). Integrated discrimination improvement index after the inclusion of GDF-15 in the model with the mortality risk factors was 0.033; that is, the ability to predict death increased by 3.3% (P = 0.004). Net reclassification improvement was 0.548 (P < 0.001); that is, the capacity to improve the classification of the event (mortality) was 54.8%. GDF-15 concentrations were divided in tertiles (<1625, 1625-4330, and >4330 ng/L), and survival curves were evaluated using the Kaplan-Meier technique. Patients in the highest tertile had the poorest 5 year survival, at 16%, whereas the lowest tertile had the best survival, of 78% (P < 0.001). Conclusions Growth differentiation factor 15 was superior to NT-proBNP for assessing prognosis in patients with HFpEF and HFmrEF. GDF-15 emerges as a strong, independent biomarker for identifying HFmrEF and HFpEF patients with worse prognosis.

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Circulating biomarkers of hypertrophy and fibrosis in patients with hypertrophic cardiomyopathy assessed by cardiac magnetic resonance

Abstract: Although no correlation between sST2 levels and myocardial fibrosis was found, sST2 may provide some additional information about hypertrophy extension. NT-proBNP and hs-cTnT are useful biomarkers in assessment of hypertrophy and fibrosis in HCM.

Cited by 26 publications

References 30 publications

Effect of feline characteristics on plasma N‐terminal‐prohormone B‐type natriuretic peptide concentration and comparison of a point‐of‐care test and an ELISA test

Effect of feline characteristics on plasma N‐terminal‐prohormone B‐type natriuretic peptide concentration and comparison of a point‐of‐care test and an ELISA test

Elevated level of N-terminal pro B-type natriuretic peptide is associated with myocardial fibrosis in hypertrophic cardiomyopathy patients with preserved ejection fraction

Growth differentiation factor 15 as mortality predictor in heart failure patients with non‐reduced ejection fraction

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