Bioactive adrenomedullin for assessment of venous congestion in heart failure
Abstract Aims Bioactive adrenomedullin (bio‐ADM) is a vascular‐derived peptide hormone that has emerged as a promising biomarker for assessment of congestion in decompensated heart failure (HF). We aimed to evaluate diagnostic and prognostic performance of bio‐ADM for HF in comparison to amino‐termi...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-10-01
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| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.14018 |
| _version_ | 1797794330372472832 |
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| author | Anna Egerstedt Tomasz Czuba Kevin Bronton Carl Lejonberg Thoralph Ruge Torgny Wessman Göran Rådegran Janin Schulte Oliver Hartmann Olle Melander J. Gustav Smith |
| author_facet | Anna Egerstedt Tomasz Czuba Kevin Bronton Carl Lejonberg Thoralph Ruge Torgny Wessman Göran Rådegran Janin Schulte Oliver Hartmann Olle Melander J. Gustav Smith |
| author_sort | Anna Egerstedt |
| collection | DOAJ |
| description | Abstract Aims Bioactive adrenomedullin (bio‐ADM) is a vascular‐derived peptide hormone that has emerged as a promising biomarker for assessment of congestion in decompensated heart failure (HF). We aimed to evaluate diagnostic and prognostic performance of bio‐ADM for HF in comparison to amino‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP), with decision thresholds derived from invasive haemodynamic and population‐based studies. Methods and results Normal reference ranges for bio‐ADM were derived from a community‐based cohort (n = 5060). Correlations with haemodynamic data were explored in a cohort of HF patients undergoing right heart catheterization (n = 346). Mortality and decision cutoffs for bio‐ADM was explored in a cohort of patients presenting in the ER with acute dyspnoea (n = 1534), including patients with decompensated HF (n = 570). The normal reference range was 8–39 pg/mL. The area under the receiver operating characteristic curve (AUROC) for discrimination of elevated mean right atrial pressure (mRAP) and pulmonary arterial wedge pressure (PAWP) was 0.74 (95% CI = 0.67–0.79) and 0.70 (95% CI = 0.64–0.75), respectively, with optimal bio‐ADM decision cutoff of 39 pg/mL, concordant with cubic spline analyses. NT‐proBNP discriminated PAWP slightly better than mRAP (AUROC 0.73 [95% CI = 0.68–0.79] and 0.68 [95% CI = 0.61–0.75]). Bio‐ADM correlated with (mRAP, r = 0.55) while NT‐proBNP correlated with PAWP. Finally, a bio‐ADM decision cutoff of 39 pg/mL associated with 30 and 90 day mortality and conferred a two‐fold increased odds of HF diagnosis, independently from NT‐proBNP. Conclusions Bio‐ADM tracks with mRAP and associates with measures of systemic congestion and with mortality in decompensated HF independently from NT‐proBNP. Our findings support utility of bio‐ADM as a biomarker of systemic venous congestion in HF and nominate a decision threshold. |
| first_indexed | 2024-03-13T03:01:12Z |
| format | Article |
| id | doaj.art-ff8deddadfd0442087c3c67ab53ffd2e |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-03-13T03:01:12Z |
| publishDate | 2022-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-ff8deddadfd0442087c3c67ab53ffd2e2023-06-27T14:49:57ZengWileyESC Heart Failure2055-58222022-10-01953543355510.1002/ehf2.14018Bioactive adrenomedullin for assessment of venous congestion in heart failureAnna Egerstedt0Tomasz Czuba1Kevin Bronton2Carl Lejonberg3Thoralph Ruge4Torgny Wessman5Göran Rådegran6Janin Schulte7Oliver Hartmann8Olle Melander9J. Gustav Smith10Department of Cardiology, Clinical Sciences Lund University Lund SwedenDepartment of Cardiology, Clinical Sciences Lund University Lund SwedenDepartment of Internal Medicine Skåne University Hospital Malmö SwedenDepartment of Cardiology, Clinical Sciences Lund University Lund SwedenDepartment of Internal Medicine Skåne University Hospital Malmö SwedenDepartment of Internal Medicine Skåne University Hospital Malmö SwedenDepartment of Cardiology, Clinical Sciences Lund University Lund SwedenSphingoTec GmbH Hennigsdorf GermanySphingoTec GmbH Hennigsdorf GermanyDepartment of Internal Medicine Skåne University Hospital Malmö SwedenDepartment of Cardiology, Clinical Sciences Lund University Lund SwedenAbstract Aims Bioactive adrenomedullin (bio‐ADM) is a vascular‐derived peptide hormone that has emerged as a promising biomarker for assessment of congestion in decompensated heart failure (HF). We aimed to evaluate diagnostic and prognostic performance of bio‐ADM for HF in comparison to amino‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP), with decision thresholds derived from invasive haemodynamic and population‐based studies. Methods and results Normal reference ranges for bio‐ADM were derived from a community‐based cohort (n = 5060). Correlations with haemodynamic data were explored in a cohort of HF patients undergoing right heart catheterization (n = 346). Mortality and decision cutoffs for bio‐ADM was explored in a cohort of patients presenting in the ER with acute dyspnoea (n = 1534), including patients with decompensated HF (n = 570). The normal reference range was 8–39 pg/mL. The area under the receiver operating characteristic curve (AUROC) for discrimination of elevated mean right atrial pressure (mRAP) and pulmonary arterial wedge pressure (PAWP) was 0.74 (95% CI = 0.67–0.79) and 0.70 (95% CI = 0.64–0.75), respectively, with optimal bio‐ADM decision cutoff of 39 pg/mL, concordant with cubic spline analyses. NT‐proBNP discriminated PAWP slightly better than mRAP (AUROC 0.73 [95% CI = 0.68–0.79] and 0.68 [95% CI = 0.61–0.75]). Bio‐ADM correlated with (mRAP, r = 0.55) while NT‐proBNP correlated with PAWP. Finally, a bio‐ADM decision cutoff of 39 pg/mL associated with 30 and 90 day mortality and conferred a two‐fold increased odds of HF diagnosis, independently from NT‐proBNP. Conclusions Bio‐ADM tracks with mRAP and associates with measures of systemic congestion and with mortality in decompensated HF independently from NT‐proBNP. Our findings support utility of bio‐ADM as a biomarker of systemic venous congestion in HF and nominate a decision threshold.https://doi.org/10.1002/ehf2.14018Heart failureBiomarkerCongestionBioactive adrenomedullinHaemodynamicsPrognosis |
| spellingShingle | Anna Egerstedt Tomasz Czuba Kevin Bronton Carl Lejonberg Thoralph Ruge Torgny Wessman Göran Rådegran Janin Schulte Oliver Hartmann Olle Melander J. Gustav Smith Bioactive adrenomedullin for assessment of venous congestion in heart failure ESC Heart Failure Heart failure Biomarker Congestion Bioactive adrenomedullin Haemodynamics Prognosis |
| title | Bioactive adrenomedullin for assessment of venous congestion in heart failure |
| title_full | Bioactive adrenomedullin for assessment of venous congestion in heart failure |
| title_fullStr | Bioactive adrenomedullin for assessment of venous congestion in heart failure |
| title_full_unstemmed | Bioactive adrenomedullin for assessment of venous congestion in heart failure |
| title_short | Bioactive adrenomedullin for assessment of venous congestion in heart failure |
| title_sort | bioactive adrenomedullin for assessment of venous congestion in heart failure |
| topic | Heart failure Biomarker Congestion Bioactive adrenomedullin Haemodynamics Prognosis |
| url | https://doi.org/10.1002/ehf2.14018 |
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