title: Clinical significance of N-terminal-probrain natriuretic peptide in hypertrophic cardiomyopathy.
abstract: 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.
authors: First Cardiology Department, AHEPA Hospital, Aristotle University, Thessaloniki, Greece. efthymos@med.auth.gr
authors: Georgios K
authors: GK
authors: Efthimiadis
authors: Areti
authors: A
authors: Hitoglou-Makedou
authors: Georgios
authors: G
authors: Giannakoulas
authors: Anastasia
authors: A
authors: Mitakidou
authors: Theodoros
authors: T
authors: Karamitsos
authors: Haralambos
authors: H
authors: Karvounis
authors: Sotirios
authors: S
authors: Mochlas
authors: Ioannis
authors: I
authors: Styliadis
authors: Haris
authors: H
authors: Stefanidis
authors: Georgios
authors: G
authors: Parcharidis
authors: Georgios
authors: G
authors: Louridas
mesh_terms: 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
chemical_list: D020097:Natriuretic Peptide, Brain