title: Relationships between biomarkers and left ventricular filling pressures at rest and during exercise in patients after myocardial infarction.
abstract: BACKGROUND
  Increased pulmonary capillary wedge pressure (PCWP) is an independent prognostic predictor after myocardial infarction (MI), but PCWP is difficult to assess noninvasively in subjects with preserved ejection fraction (EF). We hypothesized that biomarkers would provide information regarding PCWP at rest and during exercise in subjects with preserved EF after MI.
  
  
  RESULTS
  Seventy-four subjects with EF >45% and recent MI underwent right heart catheterization at rest and during a symptom-limited semisupine cycle exercise test with simultaneous echocardiography. Plasma samples were collected at rest for assessment of midregional pro-A-type natriuretic peptide (MR-proANP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), galectin-3 (Gal-3), copeptin, and midregional pro-adrenomedullin (MR-proADM). Plasma levels of MR-proANP and PCWP were associated at rest (r = 0.33; P = .002) and peak exercise (r = 0.35; P = .002) as well as with changes in PCWP (r = 0.26; P = .03). Plasma levels of NT-proBNP and PCWP were weakly associated at rest (r = 0.23; P = .03) and peak exercise (r = 0.28; P = .02) but not with changes in PCWP (r = 0.20; P = .09). In a multivariable analysis, plasma levels of MR-proANP remained associated with rest and exercise PCWP (P < .01), whereas NT-proBNP did not. Plasma levels of Gal-3, copeptin, and MR-proADM were not associated with PCWP at rest or peak exercise.
  
  
  CONCLUSIONS
  In subjects recovering from an acute MI with preserved EF, plasma levels of natriuretic peptides, particularly MR-proANP, are associated with filling pressures at rest and during exercise.
authors.affiliation: Department of Cardiology, Heart Center, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark; Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota. Electronic address: madsand@dadlnet.dk.
authors.forename: Mads J
authors.initials: MJ
authors.lastname: Andersen
authors.affiliation: Department of Cardiology, Heart Center, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.
authors.forename: Mads
authors.initials: M
authors.lastname: Ersbøll
authors.affiliation: Department of Cardiology, Heart Center, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.
authors.forename: John
authors.initials: J
authors.lastname: Bro-Jeppesen
authors.affiliation: Department of Cardiology, Heart Center, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.
authors.forename: Jacob E
authors.initials: JE
authors.lastname: Møller
authors.affiliation: Department of Cardiology, Heart Center, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Hassager
authors.affiliation: Department of Cardiology, Heart Center, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Køber
authors.affiliation: Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: Barry A
authors.initials: BA
authors.lastname: Borlaug
authors.affiliation: Department of Biochemistry, Rigshospitalet and University of Aarhus, Aarhus, Denmark.
authors.forename: Jens P
authors.initials: JP
authors.lastname: Goetze
authors.affiliation: Department of Cardiology, Heart Center, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.
authors.forename: Finn
authors.initials: F
authors.lastname: Gustafsson
mesh_terms: D053607:Adrenomedullin / Q000097:blood; D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D006328:Cardiac Catheterization / Q000379:methods; D005080:Exercise Test; D005260:Female; D037502:Galectin 3 / Q000097:blood; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D009203:Myocardial Infarction / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy; D011379:Prognosis; D011669:Pulmonary Wedge Pressure / Q000502:physiology; D012680:Sensitivity and Specificity; D015996:Survival Rate; D017725:Ventricular Pressure / Q000502:physiology*
chemical_list: D015415:Biomarkers; D037502:Galectin 3; D053607:Adrenomedullin; D009320:Atrial Natriuretic Factor
keywords: Acute myocardial infarction; biomarkers; exercise testing; hemodynamics