title: Biomarkers of hemodynamic stress and aortic stiffness after STEMI: a cross-sectional analysis.
abstract: OBJECTIVE
  Increased aortic stiffness might adversely affect cardiac structure, function, and perfusion. Release of biomarkers of hemodynamic stress is thought to be enhanced by these alterations. We aimed to evaluate the association between biomarkers of hemodynamic stress and aortic stiffness assessed at a chronic stage after ST-segment elevation myocardial infarction (STEMI).
  
  
  METHODS
  Fifty-four patients four months after STEMI were enrolled in this cross-sectional, single-center study. N-terminal pro-B-type natriuretic peptide (NT-proBNP), mid-regional pro-A-type natriuretic peptide (MR-proANP), and mid-regional proadrenomedullin (MR-proADM) levels were measured by established assays. Aortic stiffness was assessed by the measurement of pulse wave velocity using phase-contrast cardiovascular magnetic resonance.
  
  
  RESULTS
  NT-proBNP, MR-proANP, and MR-proADM concentrations were all correlated with aortic stiffness in univariate analysis (r = 0.378, r = 0.425, and r = 0.532; all P < 0.005, resp.). In multiple linear regression analysis, NT-proBNP (β = 0.316, P = 0.005) and MR-proADM (β = 0.284, P < 0.020) levels were associated with increased aortic stiffness independently of age, blood pressure, and renal function. NT-proBNP was the strongest predictor for high aortic stiffness (area under the curve: 0.82, 95% CI 0.67-0.96).
  
  
  CONCLUSIONS
  At a chronic stage after STEMI, concentrations of biomarkers for hemodynamic stress, especially NT-proBNP, are positively correlated with aortic stiffness. These biomarkers might also be useful as predictors of high aortic stiffness after STEMI.
authors.affiliation: University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
authors.forename: Sebastian Johannes
authors.initials: SJ
authors.lastname: Reinstadler
authors.affiliation: University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
authors.forename: Hans-Josef
authors.identifier: 0000-0002-6208-5316
authors.initials: HJ
authors.lastname: Feistritzer
authors.affiliation: University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
authors.forename: Gert
authors.initials: G
authors.lastname: Klug
authors.affiliation: Department of Radiology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
authors.forename: Agnes
authors.initials: A
authors.lastname: Mayr
authors.affiliation: University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
authors.forename: Luc
authors.initials: L
authors.lastname: Huybrechts
authors.affiliation: Central Institute for Medical and Chemical Laboratory Diagnostics, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
authors.forename: Angelika
authors.identifier: 0000-0002-9762-827X
authors.initials: A
authors.lastname: Hammerer-Lercher
authors.affiliation: University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
authors.forename: Johannes
authors.initials: J
authors.lastname: Mair
authors.affiliation: University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
authors.forename: Wolfgang-Michael
authors.initials: WM
authors.lastname: Franz
authors.affiliation: University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Metzler
mesh_terms: D053607:Adrenomedullin / Q000097:blood*; D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000503:physiopathology; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011498:Protein Precursors / Q000097:blood*; D011674:Pulse; D013312:Stress, Physiological; D059289:Vascular Stiffness
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D011498:Protein Precursors; C109794:pro-brain natriuretic peptide (1-76); C088633:proadrenomedullin; D020097:Natriuretic Peptide, Brain; D053607:Adrenomedullin; D009320:Atrial Natriuretic Factor