CardiomyopathyUsefulness of N-Terminal Pro-B-Type Natriuretic Peptide Levels to Predict Exercise Capacity in Hypertrophic Cardiomyopathy
Section snippets
Patient selection
One hundred seventy-one consecutive patients (63 male patients; mean age 46 ± 18 years, range 15 to 89) from the HC clinic at St. George’s Hospital, London, United Kingdom, underwent histories, examinations, 12-lead electrocardiography, echocardiography, and cardiopulmonary exercise testing. The diagnosis of HC was based on the echocardiographic demonstration of LV hypertrophy >2 SD for age and gender or on published criteria for the diagnosis of disease in relatives.23, 24 Patients unable to
Baseline characteristics of patients studied
Clinical characteristics are listed in Table 1. The mean maximal LV wall thickness of patients studied was 20 ± 5 mm (range 13 to 40). Ten patients (6.5%) had LV hypertrophy at initial presentation but at the time of study had evidence of wall thinning, cavity enlargement, and systolic impairment (fractional shortening <25%). All were in NYHA class III. One patient had severe restrictive physiology, with a maximal LV wall thickness of 23 mm, bi-atrial dilation, atrial fibrillation, and normal
Discussion
This study demonstrates that there is an inverse relation between peak oxygen consumption during upright exercise and NT–pro-BNP levels. Although percent VO2max was related to other commonly used markers of disease severity, such as LV outflow tract obstruction, fractional shortening, left atrial size, and NYHA class, only NT–pro-BNP levels retained a correlation (albeit weak) with percent VO2max in the multivariate analysis. Therefore, NT–pro-BNP level may be a more useful marker of disease
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Relationship between measures of left ventricular systolic and diastolic dysfunction and clinical and biomarker status in patients with hypertrophic cardiomyopathy
2022, Archives of Cardiovascular DiseasesCitation Excerpt :Currently, N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin I (hs-cTnI) facilitate diagnosis, improve clinical and therapeutic management, both early and late in the course of the disease, and show a potential role for risk stratification. Elevated NT-proBNP is significantly associated with more severe disease, independent of LVEF, New York Heart Association (NYHA) class and left ventricular outflow tract (LVOT) obstruction [6–8]. An integrated approach combining laboratory assays with imaging could lead to better identification of patients with worse outcome.
Platelet Function Analyzer 100 and Brain Natriuretic Peptide as Biomarkers in Obstructive Hypertrophic Cardiomyopathy
2018, American Journal of CardiologyClinical utility of natriuretic peptides and troponins in hypertrophic cardiomyopathy
2016, International Journal of CardiologyCitation Excerpt :Atrial fibrillation is a common complication of HCM occurring in about 25% of patients and is a marker of poor prognosis [24,40]. Six of seven studies, summarized in Table S2d, demonstrate that atrial fibrillation is more common among HCM patients with elevated natriuretic peptides [8,23,32,33,35,41,42]. The prevalence of atrial fibrillation among patients with elevated BNP ≥ 200 pg/mL was 42% in one cohort, compared to 8% in patients without elevated BNP [23], and the prevalence varies with natriuretic peptide levels [35].
Efficacy and safety of the angiotensin II receptor blocker losartan for hypertrophic cardiomyopathy: The INHERIT randomised, double-blind, placebo-controlled trial
2015, The Lancet Diabetes and EndocrinologyExercise Eco-Doppler in hypertrophic cardiomyopathy patients. Determinant factors of exercise intolerance
2013, Revista Espanola de CardiologiaDeterminants of Elevated NT-proBNP Levels in Patients With Hypertrophic Cardiomyopathy: An Echocardiographic Study
2009, Heart Lung and Circulation
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Drs. Thaman and Tome were supported by the British Heart Foundation, London, United Kingdom.