Superiority of proatrial natriuretic peptide in the prognostic power in patients with acute decompensated heart failure on hospital admission: Comparison with B-type natriuretic peptide and other natriuretic peptide forms

Seiji Takashio, Hiroyuki Takahama, Toshio Nishikimi, Tomohiro Hayashi, Chiaki Nagai-Okatani, Ayaka Matsuo, Yasuaki Nakagawa, Masashi Amano, Yasuhiro Hamatani, Atsushi Okada, Makoto Amaki, Takuya Hasegawa, Hideaki Kanzaki, Satoshi Yasuda, Kenji Kangawa, Toshihisa Anzai, Naoto Minamino, Chisato Izumi

研究成果: Article査読

1 被引用数 (Scopus)

抄録

Aims There are significant differences in how atrial (A-type) and B-type natriuretic peptide (ANP and BNP) are secreted and metabolised, but there is little information available about the relative clinical significance of the two peptides. The aim of the present study was to investigate: (1) the association between the circulating level of each ANP molecular form and patient clinical background and (2) their prognostic power for patients with acute decompensated heart failure (ADHF). Methods We used specific chemiluminescence enzyme immunoassays to prospectively evaluate the levels of six bioactive molecular forms of ANP (pro-ANP, β-ANP and total ANP) and BNP (pro-BNP, N-terminal pro-BNP (NT-pro-BNP) and total BNP) in plasma samples collected from 173 patients with ADHF on their hospital admission. Results We found that pro-ANP levels were strongly associated with left ventricular (LV) size and ejection fraction (p<0.001), but were not associated with left atrial size. Percent pro-ANP ([pro-ANP/total ANP]x100) was also associated with LV size and function. During the follow-up term (median: 469 days), composite adverse events (all causes of death or rehospitalisation for HF) occurred in 67 patients (38.7 %). Pro-ANP was significantly associated with composite adverse events even after adjusting by estimated glomerular filtration rate (eGFR) (p<0.05). In contrast, NT-pro-BNP was not independent of eGFR in the multivariate analysis. Conclusion Circulating levels of pro-ANP are strongly associated with LV function and clinical outcomes of patients with ADHF. These findings suggest that during the acute phases of HF, pro-ANP has a prognostic power comparable with NT-pro-BNP independently of renal function.

本文言語English
論文番号e001072
ジャーナルOpen Heart
6
2
DOI
出版ステータスPublished - 2019 7 1
外部発表はい

ASJC Scopus subject areas

  • 循環器および心血管医学

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「Superiority of proatrial natriuretic peptide in the prognostic power in patients with acute decompensated heart failure on hospital admission: Comparison with B-type natriuretic peptide and other natriuretic peptide forms」の研究トピックを掘り下げます。これらがまとまってユニークなフィンガープリントを構成します。

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