Simon F Stämpfli1, Ladina Erhart1, Niels Hagenbuch2, Barbara E Stähli1, Christiane Gruner1, Matthias Greutmann1, Markus Niemann3, Beat A Kaufmann4, Rolf Jenni1, Leonhard Held2, Felix C Tanner5. 1. Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland. 2. Department of Biostatistics, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland. 3. Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland; Faculty Mechanical and Medical Engineering, Furtwangen University, Furtwangen, Germany. 4. Department of Cardiology, University Hospital Basel, Basel, Switzerland. 5. Department of Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland. Electronic address: felix.tanner@usz.ch.
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. CONCLUSION: 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.
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. CONCLUSION: 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: Elham Kayvanpour; Farbod Sedaghat-Hamedani; Weng-Tein Gi; Oguz Firat Tugrul; Ali Amr; Jan Haas; Feng Zhu; Philipp Ehlermann; Lorenz Uhlmann; Hugo A Katus; Benjamin Meder Journal: Clin Res Cardiol Date: 2019-04-12 Impact factor: 5.460
Authors: Nay Aung; Sara Doimo; Fabrizio Ricci; Mihir M Sanghvi; Cesar Pedrosa; Simon P Woodbridge; Amer Al-Balah; Filip Zemrak; Mohammed Y Khanji; Patricia B Munroe; Huseyin Naci; Steffen E Petersen Journal: Circ Cardiovasc Imaging Date: 2020-01-21 Impact factor: 7.792
Authors: Simon F Stämpfli; Alexander Gotschy; Pascal Kiarostami; Tardu Özkartal; Christiane Gruner; Markus Niemann; Robert Manka; Felix C Tanner Journal: Cardiol J Date: 2020-07-10 Impact factor: 3.487