Cardiac magnetic resonance left ventricular filling pressure is associated with NT-proBNP in patients with new onset heart failure

Assadi, Hosamadin ORCID:, Matthews, Gareth ORCID:, Chambers, Bradley, Grafton-Clarke, Ciaran ORCID:, Shabi, Mubien, Plein, Sven, Swoboda, Peter P. and Garg, Pankaj ORCID: (2023) Cardiac magnetic resonance left ventricular filling pressure is associated with NT-proBNP in patients with new onset heart failure. Medicina, 59 (11). ISSN 1648-9144

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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.

Item Type: Article
Additional Information: Funding information: P.G. is funded by the Wellcome Trust Clinical Research Career Development Fellowship (220703/Z/20/Z). The funders had no role in the study design, data collection, analysis, publishing decisions, or manuscript preparation. Rights retention statement: For Open Access purposes, the authors have applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission.
Uncontrolled Keywords: cmr,mri,diastole,heart failure,left ventricular end-diastolic pressure,medicine(all) ,/dk/atira/pure/subjectarea/asjc/2700
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health
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Depositing User: LivePure Connector
Date Deposited: 01 Nov 2023 03:30
Last Modified: 22 Jul 2024 16:31
DOI: 10.3390/medicina59111924


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