Clinical significance of N-terminal-probrain natriuretic peptide in hypertrophic cardiomyopathy.
N-Terminal-probrain natriuretic peptide (NT-proBNP) plasma levels are elevated in patients with congestive heart failure. Published data concerning the utility of NT-proBNP in hypertrophic cardiomyopathy (HCM) are lacking. Our aim was to evaluate the clinical significance of NT-proBNP in patients with HCM. A blood sample was collected for plasma NT-proBNP measurement from 43 consecutive patients with documented HCM. NT-proBNP was measured using a chemiluminescent immunoassay kit (Roche Diagnostics) on an Elecsys 2010 analyzer. Median value of NT-proBNP was 219 pg/ml (range 8-3 045 pg/ml) in NYHA class I patients, 698 pg/ml (125-2 463 pg/ml) in NYHA class II patients, and 2 683 pg/ml (131-11 542 pg/ml) in NYHA class III and IV patients. NT-proBNP plasma levels were significantly higher across the severity of functional limitation (i.e., NYHA class classification) (P = 0.002). NT-proBNP levels were significantly higher in female than male (P = 0.034), in referral vs nonreferral patients (P = 0.004), in symptomatic vs asymptomatic patients (P = 0.020), in patients with basal subaortic gradient >or=30 mmHg (P = 0.001) and in the patients who were on cardioactive medication (P = 0.010). In univariate analysis NT-proBNP was significantly correlated with age (P < 0.001), left ventricular maximum wall thickness (P = 0.001), left atrial size (P = 0.019), and subaortic gradient >or=30 mmHg (P < 0.001). In multivariate regression analysis, age (P < 0.001), maximum wall thickness (P = 0.007), and gradient >or=30 mmHg (P = 0.027) were independently associated with NT-proBNP levels. Our data support the idea that measurement of plasma NT-proBNP levels in HCM patients is useful to assess their clinical status, especially the severity of hypertrophy and the presence of obstruction, although age must be taken into account.
Efthimiadis
Georgios K
GK
First Cardiology Department, AHEPA Hospital, Aristotle University, Thessaloniki, Greece. efthymos@med.auth.gr
Hitoglou-Makedou
Areti
A
Giannakoulas
Georgios
G
Mitakidou
Anastasia
A
Karamitsos
Theodoros
T
Karvounis
Haralambos
H
Mochlas
Sotirios
S
Styliadis
Ioannis
I
Stefanidis
Haris
H
Parcharidis
Georgios
G
Louridas
Georgios
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002312:Cardiomyopathy, Hypertrophic / Q000378:metabolism*; D015331:Cohort Studies; D004452:Echocardiography / Q000379:methods; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D020097:Natriuretic Peptide, Brain / Q000737:chemistry*; D017434:Protein Structure, Tertiary; D012044:Regression Analysis
D020097:Natriuretic Peptide, Brain