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Yuichiro Minami
Department School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine Position Associate Professor |
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| Article types | Original article |
| Language | English |
| Peer review | Peer reviewed |
| Title | B-type natriuretic peptide and outcome in patients with apical hypertrophic cardiomyopathy. |
| Journal | Formal name：Journal of cardiology Abbreviation：J Cardiol ISSN code：09145087/18764738 |
| Domestic / Foregin | Foregin |
| Publisher | Elsevier publishes on behalf of the Japanese College of Cardiology |
| Volume, Issue, Page | pp.in press |
| Author and coauthor | SHIROTANI Shota†, MINAMI Yuichiro*, SAITO Chihiro, HARUKI Shintaro, HAGIWARA Nobuhisa |
| Authorship | Corresponding author |
| Publication date | 2020/05 |
| Summary | BACKGROUND:Although elevated B-type natriuretic peptide (BNP) levels predict outcome in patients with hypertrophic cardiomyopathy (HCM), the association between BNP levels and outcome in patients with the apical phenotype of HCM remains unclear. We evaluated the impact of elevated BNP levels on outcome in a cohort of apical HCM patients.
METHODS:Among 432 HCM patients, 144 with an apical phenotype were examined. Plasma BNP levels were measured at the time of the initial evaluation. RESULTS:The median (interquartile range) BNP level at initial evaluation in these patients was 188.5 (72.0-334.4) pg/mL. During a median follow-up period of 9.5 years, 34 patients experienced HCM-related adverse outcomes, including 2 patients with sudden death, 5 with appropriate implantable defibrillator shocks, 3 with stroke-related death, 8 with non-fatal stroke, and 16 with heart failure hospitalization. Receiver operating characteristic (ROC) curve analysis of the prognostic value of BNP for the combined endpoint gave an area under the ROC curve of 0.756, and optimal BNP cut-off point of 226.0pg/mL. Patients with high BNP levels (≥226.0pg/mL) were at significantly greater risk of the combined endpoint (log-rank p<0.001) than patients with low BNP levels. Multivariable analysis that included BNP levels and potential confounders showed that high BNP levels were an independent determinant of the combined endpoint (adjusted hazard ratio: 3.71; p=0.002). CONCLUSIONS:Measuring BNP may help stratify the risk of HCM-related adverse outcome in apical HCM patients. |
| DOI | 10.1016/j.jjcc.2020.03.015 |
| PMID | 32439341 |