Serum N-terminal pro-B-type natriuretic peptide levels are associated with left atrial dilation, resting left ventricular outflow tract gradient, and pulmonary hypertension in patients with hypertrophic cardiomyopathy

Adam Gębka; Renata Rajtar-Salwa; Artur Dziewierz; Paweł Petkow-Dimitrow

doi:10.5114/aic.2019.91516

Abstract

1/2020 vol. 16

Original paper

Serum N-terminal pro-B-type natriuretic peptide levels are associated with left atrial dilation, resting left ventricular outflow tract gradient, and pulmonary hypertension in patients with hypertrophic cardiomyopathy

Adam Gębka ¹

,

Renata Rajtar-Salwa ¹

,

Artur Dziewierz ²

,

Paweł Petkow-Dimitrow ²

Second Department of Cardiology and Cardiovascular Interventions, University Hospital Krakow, Poland
Second Department of Cardiology, Jagiellonian University Medical College, Krakow

Adv Interv Cardiol 2020; 16, 1 (59): 97–101

DOI: https://doi.org/10.5114/aic.2019.91516

Online publish date: 2020/01/09

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AMA

Gębka A, Rajtar-Salwa R, Dziewierz A, Petkow-Dimitrow P. Serum N-terminal pro-B-type natriuretic peptide levels are associated with left atrial dilation, resting left ventricular outflow tract gradient, and pulmonary hypertension in patients with hypertrophic cardiomyopathy. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2020;16(1):97-101. doi:10.5114/aic.2019.91516.

APA

Gębka, A., Rajtar-Salwa, R., Dziewierz, A., & Petkow-Dimitrow, P. (2020). Serum N-terminal pro-B-type natriuretic peptide levels are associated with left atrial dilation, resting left ventricular outflow tract gradient, and pulmonary hypertension in patients with hypertrophic cardiomyopathy. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 16(1), 97-101. https://doi.org/10.5114/aic.2019.91516

Chicago

Gębka, Adam, Renata Rajtar-Salwa, Artur Dziewierz, and Paweł Petkow-Dimitrow. 2020. "Serum N-terminal pro-B-type natriuretic peptide levels are associated with left atrial dilation, resting left ventricular outflow tract gradient, and pulmonary hypertension in patients with hypertrophic cardiomyopathy". Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej 16 (1): 97-101. doi:10.5114/aic.2019.91516.

Harvard

Gębka, A., Rajtar-Salwa, R., Dziewierz, A., and Petkow-Dimitrow, P. (2020). Serum N-terminal pro-B-type natriuretic peptide levels are associated with left atrial dilation, resting left ventricular outflow tract gradient, and pulmonary hypertension in patients with hypertrophic cardiomyopathy. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 16(1), pp.97-101. https://doi.org/10.5114/aic.2019.91516

MLA

Gębka, Adam et al. "Serum N-terminal pro-B-type natriuretic peptide levels are associated with left atrial dilation, resting left ventricular outflow tract gradient, and pulmonary hypertension in patients with hypertrophic cardiomyopathy." Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, vol. 16, no. 1, 2020, pp. 97-101. doi:10.5114/aic.2019.91516.

Vancouver

Gębka A, Rajtar-Salwa R, Dziewierz A, Petkow-Dimitrow P. Serum N-terminal pro-B-type natriuretic peptide levels are associated with left atrial dilation, resting left ventricular outflow tract gradient, and pulmonary hypertension in patients with hypertrophic cardiomyopathy. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2020;16(1):97-101. doi:10.5114/aic.2019.91516.

Introduction

N-terminal pro-B-type natriuretic peptide (NT-proBNP) can be a marker of left ventricle (LV) pressure overload in hypertrophic cardiomyopathy (HCM). The different clinical characteristics of HCM might correspond to the degree of NT-proBNP increase.

Aim

This study aimed to establish whether the left atrium (LA) dimension, left ventricle outflow tract (LVOT) gradient, and pulmonary hypertension influence NT-proBNP serum levels in patients with HCM.

Material and methods

In 62 HCM patients (32 males and 30 females, mean age 31 ±11 years), echocardiography with LV outflow tract gradient provocation was performed using natural stimuli > 30 mm Hg (NOHCM – 36 patients, POHCM – 12 patients, HOCM – 14 patients).

Results

Smaller LAD was associated with a lower NT-proBNP/ULN level (p = 0.001). In contrast, smaller vs. larger LAD subgroups did not differ in NT-proBNP level (p = 0.42). Both NT-proBNP/ULN and NTproBNP were significantly elevated in the subgroup with lager LAA. The absolute value of NT-proBNP was significantly higher in the HOCM subgroup (NOHCM vs. POHCM vs. HOCM (p = 0.02). Similarly, NT-proBNP/ULN was significantly higher in the HOCM subgroup (NOHCM vs. POHCM vs. HOCM, p = 0.00047). This elevated value of biomarker is related to pulmonary hypertension.

Conclusions

Increased NT-proBNP/ULN is positively associated with larger LAD and LAA, while elevated NTproBNP is only associated with larger LAA. The highest levels of both NT-proBNP and NTproBNP/ULN were associated with HOCM and pulmonary hypertension, whereas biomarker levels were comparably lower in both the POHCM and NOHCM.

Keywords

hypertrophic cardiomyopathy, biomarker, NT-proBNP, pulmonary hypertension

Abstract

Serum N-terminal pro-B-type natriuretic peptide levels are associated with left atrial dilation, resting left ventricular outflow tract gradient, and pulmonary hypertension in patients with hypertrophic cardiomyopathy

Introduction

Aim

Material and methods

Results

Conclusions

Keywords

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