Cardiac Magnetic Resonance Left Ventricular Filling Pressure Is Associated with NT-proBNP in Patients with New Onset Heart Failure
<i>Background and Objectives</i>: 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 cardia...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-10-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/11/1924 |
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| author | Hosamadin Assadi Gareth Matthews Bradley Chambers Ciaran Grafton-Clarke Mubien Shabi Sven Plein Peter P Swoboda Pankaj Garg |
| author_facet | Hosamadin Assadi Gareth Matthews Bradley Chambers Ciaran Grafton-Clarke Mubien Shabi Sven Plein Peter P Swoboda Pankaj Garg |
| author_sort | Hosamadin Assadi |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: 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). <i>Materials and Methods</i>: 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. <i>Results</i>: In total, 305 patients had NT-proBNP ≥ 125 pg/mL. Patients with raised NT-proBNP were older (54 ± 14 vs. 64 ± 11 years, <i>p <</i> 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, <i>p</i> < 0.0001). The serum levels of NT-proBNP were associated with CMR-derived LVFP (R = 0.42, <i>p</i> < 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, <i>p</i> = 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, <i>p</i> = 0.01). <i>Conclusions:</i> 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. |
| first_indexed | 2024-03-09T16:38:44Z |
| format | Article |
| id | doaj.art-fae4440e62ae464fa320f50c8e77219d |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T16:38:44Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
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| series | Medicina |
| spelling | doaj.art-fae4440e62ae464fa320f50c8e77219d2023-11-24T14:54:42ZengMDPI AGMedicina1010-660X1648-91442023-10-015911192410.3390/medicina59111924Cardiac Magnetic Resonance Left Ventricular Filling Pressure Is Associated with NT-proBNP in Patients with New Onset Heart FailureHosamadin Assadi0Gareth Matthews1Bradley Chambers2Ciaran Grafton-Clarke3Mubien Shabi4Sven Plein5Peter P Swoboda6Pankaj Garg7Department of Cardiovascular and Metabolic Health, Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UKDepartment of Cardiovascular and Metabolic Health, Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UKDivision of Biomedical Imaging, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9JT, UKDepartment of Cardiovascular and Metabolic Health, Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UKDivision of Biomedical Imaging, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9JT, UKDivision of Biomedical Imaging, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9JT, UKDivision of Biomedical Imaging, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds LS2 9JT, UKDepartment of Cardiovascular and Metabolic Health, Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK<i>Background and Objectives</i>: 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). <i>Materials and Methods</i>: 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. <i>Results</i>: In total, 305 patients had NT-proBNP ≥ 125 pg/mL. Patients with raised NT-proBNP were older (54 ± 14 vs. 64 ± 11 years, <i>p <</i> 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, <i>p</i> < 0.0001). The serum levels of NT-proBNP were associated with CMR-derived LVFP (R = 0.42, <i>p</i> < 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, <i>p</i> = 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, <i>p</i> = 0.01). <i>Conclusions:</i> 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.https://www.mdpi.com/1648-9144/59/11/1924left ventricular end-diastolic pressureMRICMRdiastoleheart failure |
| spellingShingle | Hosamadin Assadi Gareth Matthews Bradley Chambers Ciaran Grafton-Clarke Mubien Shabi Sven Plein Peter P Swoboda Pankaj Garg Cardiac Magnetic Resonance Left Ventricular Filling Pressure Is Associated with NT-proBNP in Patients with New Onset Heart Failure Medicina left ventricular end-diastolic pressure MRI CMR diastole heart failure |
| title | Cardiac Magnetic Resonance Left Ventricular Filling Pressure Is Associated with NT-proBNP in Patients with New Onset Heart Failure |
| title_full | Cardiac Magnetic Resonance Left Ventricular Filling Pressure Is Associated with NT-proBNP in Patients with New Onset Heart Failure |
| title_fullStr | Cardiac Magnetic Resonance Left Ventricular Filling Pressure Is Associated with NT-proBNP in Patients with New Onset Heart Failure |
| title_full_unstemmed | Cardiac Magnetic Resonance Left Ventricular Filling Pressure Is Associated with NT-proBNP in Patients with New Onset Heart Failure |
| title_short | Cardiac Magnetic Resonance Left Ventricular Filling Pressure Is Associated with NT-proBNP in Patients with New Onset Heart Failure |
| title_sort | cardiac magnetic resonance left ventricular filling pressure is associated with nt probnp in patients with new onset heart failure |
| topic | left ventricular end-diastolic pressure MRI CMR diastole heart failure |
| url | https://www.mdpi.com/1648-9144/59/11/1924 |
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