Cardiac Magnetic Resonance Left Ventricular Filling Pressure Is Associated with NT-proBNP in Patients with New Onset Heart Failure

被引：4

作者：

Assadi, Hosamadin ^{[1
,2
]}

Matthews, Gareth ^{[1
,2
]}

Chambers, Bradley ^{[3
]}

Grafton-Clarke, Ciaran ^{[1
,2
]}

Shabi, Mubien ^{[3
]}

Plein, Sven ^{[3
]}

Swoboda, Peter P. ^{[3
]}

Garg, Pankaj ^{[1
,2
]}

机构：

[1] Univ East Anglia, Norwich Med Sch, Dept Cardiovasc & Metab Hlth, Norwich NR4 7TJ, England

[2] Norfolk & Norwich Univ Hosp NHS Fdn Trust, Dept Cardiol, Norwich NR4 7UY, England

[3] Univ Leeds, Leeds Inst Cardiovasc & Metab Med, Div Biomed Imaging, Leeds LS2 9JT, England

来源：

MEDICINA-LITHUANIA | 2023年 / 59卷 / 11期

基金：

英国惠康基金;

关键词：

left ventricular end-diastolic pressure; MRI; CMR; diastole; heart failure; PRESERVED EJECTION FRACTION; BRAIN NATRIURETIC PEPTIDE; AMERICAN-COLLEGE; TASK-FORCE; ECHOCARDIOGRAPHY; MANAGEMENT; GUIDELINE;

D O I：

10.3390/medicina59111924

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background and Objectives: Cardiovascular magnetic resonance (CMR) is emerging as an important imaging tool for sub-phenotyping and estimating left ventricular (LV) filling pressure (LVFP). The N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) is released from cardiac myocytes in response to mechanical load and wall stress. This study sought to investigate if CMR-derived LVFP is associated with the serum levels of NT-proBNP and, in addition, if it provides any incremental prognostic value in heart failure (HF). Materials and Methods: This study recruited 380 patients diagnosed with HF who underwent same-day CMR and clinical assessment between February 2018 and January 2020. CMR-derived LVFP was calculated, as previously, from long- and short-axis cines. During CMR assessment, serum NT-proBNP was measured. The pathological cut-offs were defined as follows: NT-proBNP >= 125 pg/mL and CMR LVFP > 15 mmHg. The incidence of HF hospitalisation was treated as a clinical outcome. Results: In total, 305 patients had NT-proBNP >= 125 pg/mL. Patients with raised NT-proBNP were older (54 +/- 14 vs. 64 +/- 11 years, p < 0.0001). Patients with raised NT-proBNP had higher LV volumes and mass. In addition, CMR LVFP was higher in patients with raised NT-proBNP (13.2 +/- 2.6 vs. 15.4 +/- 3.2 mmHg, p < 0.0001). The serum levels of NT-proBNP were associated with CMR-derived LVFP (R = 0.42, p < 0.0001). In logistic regression analysis, this association between NT-proBNP and CMR LVFP was independent of all other CMR variables, including LV ejection fraction, LV mass, and left atrial volume (coefficient = 2.02, p = 0.002). CMR LVFP demonstrated an independent association with the incidence of HF hospitalisation above NT-proBNP (hazard ratio 2.7, 95% confidence interval 1.2 to 6, p = 0.01). Conclusions: A CMR-modelled LVFP is independently associated with serum NT-proBNP levels. Importantly, it provides an incremental prognostic value over and above serum NT-proBNP levels.

引用

页数：11

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