Prognostic power of NT-proBNP in left ventricular non-compaction cardiomyopathy.

Abstract

BACKGROUND:

The risk of adverse events in patients with left ventricular non-compaction cardiomyopathy (LVNC) is substantial. This study was designed to determine the prognostic value of NT-proBNP, left ventricular ejection fraction (LVEF), NYHA class, and exercise capacity in LVNC patients.

METHODS:

Cox regression analyses were performed for evaluating the prognostic value of NT-proBNP, LVEF, NYHA class, and exercise capacity on the occurrence of death or heart transplantation. 153 patients were included.

RESULTS:

During 1013 person-years (longest follow-up 18.5years) 23 patients (15%) died or underwent heart transplantation. We observed a significant relationship of NT-proBNP (adjusted HR 2.44, 95% CI 1.45-4.09, for every NT-proBNP doubling, p=0.0007) and LVEF (adjusted HR for age 60years: 2.68, 95% CI 1.62-4.41, p=0.0001) with the risk of death or heart transplantation. Combined covariate analysis indicated a strong influence of NT-proBNP (adjusted 2.89, 95% CI 1.33-6.26, p=0.007), whereas LVEF was no longer significant (adjusted HR 0.82, 95% CI 0.42-1.67, p=0.66) demonstrating a favorable prognostic power of NT-proBNP over LVEF. An increase in NYHA class was associated with a worse outcome, and exercise capacity revealed a trend in the same direction. For all the abovementioned analyses, similar results were obtained when assessing the values at first presentation.

CONCLUSION:

This study provides evidence that an increase in NT-proBNP is a strong predictor of outcome in patients with LVNC. The prognostic power of NT-proBNP is at least as good as that of LVEF, indicating that routine NT-proBNP measurement may improve risk assessment in LVNC.

• Authors: Simon F Stämpfli, Ladina Erhart, Niels Hagenbuch, Barbara E Stähli, Christiane Gruner, Matthias Greutmann, Markus Niemann, Beat A Kaufmann, Rolf Jenni, Leonhard Held, Felix C Tanner
• Journal: International journal of cardiology (Int J Cardiol) Vol. 236 Pg. 321-327 (Jun 01 2017) ISSN: 1874-1754 [Electronic] Netherlands
• PMID: 28268080 (Publication Type: Journal Article)
• Copyright: Copyright © 2017 Elsevier B.V. All rights reserved.

Chemical References

• Biomarkers
• Peptide Fragments
• pro-brain natriuretic peptide (1-76)
• Natriuretic Peptide, Brain

Topics

• Adult
• Biomarkers (blood)
• Cardiomyopathies (blood, diagnosis, physiopathology)
• Cohort Studies
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Natriuretic Peptide, Brain (blood)
• Peptide Fragments (blood)
• Prognosis
• Retrospective Studies
• Stroke Volume (physiology)
• Ventricular Dysfunction, Left (blood, diagnosis, physiopathology)
• Ventricular Function, Left (physiology)