title: Prognostic power of NT-proBNP in left ventricular non-compaction cardiomyopathy.
abstract: BACKGROUND
  The risk of adverse events in patients with left ventricular non-compaction cardiomyopathy (LVNC) is substantial. This study was designed to determine the prognostic value of NT-proBNP, left ventricular ejection fraction (LVEF), NYHA class, and exercise capacity in LVNC patients.
  
  
  METHODS
  Cox regression analyses were performed for evaluating the prognostic value of NT-proBNP, LVEF, NYHA class, and exercise capacity on the occurrence of death or heart transplantation. 153 patients were included.
  
  
  RESULTS
  During 1013 person-years (longest follow-up 18.5years) 23 patients (15%) died or underwent heart transplantation. We observed a significant relationship of NT-proBNP (adjusted HR 2.44, 95% CI 1.45-4.09, for every NT-proBNP doubling, p=0.0007) and LVEF (adjusted HR for age 60years: 2.68, 95% CI 1.62-4.41, p=0.0001) with the risk of death or heart transplantation. Combined covariate analysis indicated a strong influence of NT-proBNP (adjusted 2.89, 95% CI 1.33-6.26, p=0.007), whereas LVEF was no longer significant (adjusted HR 0.82, 95% CI 0.42-1.67, p=0.66) demonstrating a favorable prognostic power of NT-proBNP over LVEF. An increase in NYHA class was associated with a worse outcome, and exercise capacity revealed a trend in the same direction. For all the abovementioned analyses, similar results were obtained when assessing the values at first presentation.
  
  
  CONCLUSIONS
  This study provides evidence that an increase in NT-proBNP is a strong predictor of outcome in patients with LVNC. The prognostic power of NT-proBNP is at least as good as that of LVEF, indicating that routine NT-proBNP measurement may improve risk assessment in LVNC.
authors.affiliation: Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Simon F
authors.initials: SF
authors.lastname: Stämpfli
authors.affiliation: Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Ladina
authors.initials: L
authors.lastname: Erhart
authors.affiliation: Department of Biostatistics, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
authors.forename: Niels
authors.initials: N
authors.lastname: Hagenbuch
authors.affiliation: Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Barbara E
authors.initials: BE
authors.lastname: Stähli
authors.affiliation: Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Christiane
authors.initials: C
authors.lastname: Gruner
authors.affiliation: Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Greutmann
authors.affiliation: Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland; Faculty Mechanical and Medical Engineering, Furtwangen University, Furtwangen, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Niemann
authors.affiliation: Department of Cardiology, University Hospital Basel, Basel, Switzerland.
authors.forename: Beat A
authors.initials: BA
authors.lastname: Kaufmann
authors.affiliation: Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Rolf
authors.initials: R
authors.lastname: Jenni
authors.affiliation: Department of Biostatistics, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
authors.forename: Leonhard
authors.initials: L
authors.lastname: Held
authors.affiliation: Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland. Electronic address: felix.tanner@usz.ch.
authors.forename: Felix C
authors.initials: FC
authors.lastname: Tanner
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D009202:Cardiomyopathies / Q000097:blood* / Q000175:diagnosis* / Q000503:physiopathology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000175:diagnosis* / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Ejection fraction; Heart failure; NT-proBNP; Non-compaction cardiomyopathy; Prognosis