N-terminal pro-brain natriuretic peptide and sudden cardiac death in hypertrophic cardiomyopathy

Wu, Guixin; Liu, Jie; Wang, Shuiyun; Yu, Shiqin; Zhang, Ce; Wang, Dong; Zhang, Mo; Yang, Shujuan; Kang, Lianming; Zhao, Shihua; Hui, Rutai; Zou, Yubao; Wang, Jizheng; Song, Lingyun

doi:10.1136/heartjnl-2020-317701

Cited by 20 publications

(19 citation statements)

References 24 publications

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“…Thus, the results are valuable and cannot be accidental. However, no significant differences were observed in the incidence of SCD and HFRD in the present study, which is different from previous results [11,26]. And compared with previous studies [11,27], higher mortality was observed in the present study.…”

Section: Discussioncontrasting

confidence: 99%

“…The results showed NT-proBNP remained an independent predictor of ACD and CD after adjusting for these confounders. In addition, the results were consistent with a previous report [11]. Thus, the results are valuable and cannot be accidental.…”

Section: Discussionsupporting

confidence: 92%

“…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: 98%

“…In recent years, even though The neurohormone pro-brain natriuretic peptide is synthesized and released when cardiac myocytes are exposed to hemodynamic stress [8], and it is further cleaved into N-terminal pro-brain natriuretic peptide (NT-proBNP) by proteolytic enzymes. NT-proBNP has been shown to be an effective and sensitive biomarker in heart failure [9,10] and it is also used in risk stratification of HCM and several cardiovascular disorders [11,12].…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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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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“…LVEF was calculated from two-dimensional echocardiography images using the modified Simpsons rule formula. NT-proBNP concentrations were measured as described in our previous study [ 9 ]. Specifically, venous blood samples were collected into serum separator tubes by direct venipuncture and sent to the laboratory for testing.…”

Section: Methodsmentioning

confidence: 99%

Identification of heart failure with preserved ejection fraction helps risk stratification for hypertrophic cardiomyopathy

Liu

Wang

Ruan

et al. 2022

BMC Med

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Background Heart failure with preserved ejection fraction (HFpEF) is the dominant form of heart failure (HF). We here aimed to investigate the characteristics and prognosis of HFpEF in patients with hypertrophic cardiomyopathy (HCM). Methods This was a prospective cohort study and patients with HCM with available NT-proBNP results were enrolled. Patients were categorized into HFpEF [defined as LVEF ≥50%, with symptoms or signs of HF, and N-terminal pro-brain natriuretic peptide ≥800 pg/mL according to American Heart Association (AHA) criteria] and without heart failure (non-HF). The outcomes of interest were all-cause death, cardiovascular death, and sudden cardiac death (SCD). Results Of 1178 included patients with HCM, 513 (43.5%) were identified as having HFpEF according to AHA criteria. Compared with non-HF patients, patients with HFpEF had significantly larger maximal wall thickness (P < 0.001), higher maximal left ventricular outflow tract gradient (P < 0.001), higher proportion of atrial fibrillation (P < 0.001), higher incidence of all-cause death (log-rank test, P = 0.002), and cardiovascular death (log-rank test, P = 0.005). Multivariable Cox analysis showed that patients with HFpEF had a nearly two-fold higher risk of all-cause death (adjusted HR = 1.80, 95% CI 1.11–2.90; P = 0.017) and cardiovascular death (adjusted HR =1.82, 95% CI 1.05–3.18; P = 0.033) than non-HF patients. Conclusions Patients with HCM have a high prevalence of HFpEF and those with HFpEF present greater disease severity and higher mortality than non-HF patients, and thus may require an appropriate and more aggressive treatment for HF management. Identification of patients with HFpEF using AHA criteria can provide guidance on patient risk stratification for patients with HCM.

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N‐terminal pro‐B‐type natriuretic peptide for prediction of ventricular arrhythmias: Data from the SMASH study

Sourour

Riveland

Naesgaard

et al. 2023

Clinical Cardiology

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BackgroundElevated N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) concentrations predict heart failure (HF) and mortality, but whether NT‐proBNP predicts ventricular arrhythmias (VA) is not clear.HypothesisWe hypothesize that high NT‐proBNP concentrations associate with the risk of incident VA, defined as adjudicated ventricular fibrillation or sustained ventricular tachycardia.MethodsIn a prospective, observational study of patients treated with implantable cardioverter defibrillator (ICD), we analyzed NT‐proBNP concentrations at baseline and after mean 1.4 years in association to incident VA.ResultsWe included 490 patients (age 66 ± 12 years, 83% men) out of whom 51% had a primary prevention ICD indication. The median NT‐proBNP concentration was 567 (25–75 percentile 203–1480) ng/L and patients with higher concentrations were older with more HF and ICD for primary prevention. During mean 3.1 ± 0.7 years, 137 patients (28%) had ≥1 VA. Baseline NT‐proBNP concentrations were associated with the risk of incident VA (hazard ratio [HR]: 1.39, 95% confidence interval [95% CI]: 1.22–1.58, p < .001), HF hospitalizations (HR: 3.11, 95% CI: 2.53–3.82, p < .001), and all‐cause mortality (HR: 2.49, 95% CI: 2.04–3.03, p < .001), which persisted after adjusting for age, sex, body mass index, coronary artery disease, HF, renal function, and left ventricular ejection fraction. The association with VA was stronger in secondary versus primary prevention ICD indication: HR: 1.59 (95% CI: 1.34–1.88 C‐statistics 0.71) versus HR: 1.24, 95% CI: 1.02–1.51, C‐statistics 0.55), p‐for‐interaction = 0.06. Changes in NT‐proBNP during the first 1.4 years did not associate with subsequent VA.ConclusionsNT‐proBNP concentrations are associated with the risk of incident VA after adjustment for established risk factors, with the strongest association in patients with a secondary prevention ICD indication.

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N-terminal pro-brain natriuretic peptide and sudden cardiac death in hypertrophic cardiomyopathy

Cited by 20 publications

References 24 publications

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

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

Identification of heart failure with preserved ejection fraction helps risk stratification for hypertrophic cardiomyopathy

N‐terminal pro‐B‐type natriuretic peptide for prediction of ventricular arrhythmias: Data from the SMASH study

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