title: Usefulness of N-terminal pro-B-type natriuretic peptide to predict clinical course in patients with hypertrophic cardiomyopathy.
abstract: This study was designed to assess the value of plasma N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) levels in predicting clinical courses in 80 patients with hypertrophic cardiomyopathy. Patients were followed for a mean of 571 +/- 294 days for clinical end points, defined as a composite of cardiovascular death and hospitalization for worsening heart failure symptoms. NT-pro-BNP plasma level (hazard ratio 1.6, 95% confidence interval 1.10 to 2.55, p = 0.015) and New York Heart Association (NYHA) functional class (hazard ratio 3.7, 95% confidence interval 1.17 to 12.09, p = 0.025) were the independent variables associated with increased risk for experiencing clinical end points. NT-pro-BNP plasma level > or =1,500 pg/ml detected patients with clinical end points with sensitivity, specificity, and accuracy of 83%, 81%, and 81%, respectively. The hypertrophic cardiomyopathy population was stratified into low-, medium-, and high-risk subgroups using 2 simple variables, NYHA functional class and NT-pro-BNP. Patients in lower NYHA classes and with NT-pro-BNP levels <1,500 pg/ml were significantly free of clinical end points. In conclusion, for patients with hypertrophic cardiomyopathy, plasma levels of NT-pro-BNP seem a reliable parameter to identify those at risk for clinical deterioration at long-term follow-up in conjunction with symptomatic status.
authors.affiliation: Department of Cardiology, Kosuyolu Heart and Research Hospital, Istanbul, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Mutlu
authors.forename: Fatih
authors.initials: F
authors.lastname: Bayrak
authors.forename: Gokhan
authors.initials: G
authors.lastname: Kahveci
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Degertekin
authors.forename: Elif
authors.initials: E
authors.lastname: Eroglu
authors.forename: Yelda
authors.initials: Y
authors.lastname: Basaran
mesh_terms: D015415:Biomarkers / Q000097:blood; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain