TY - JOUR
T1 - Association of pro-b-type natriuretic peptide with cardiac magnetic resonance–measured global and regional cardiac function and structure over 10 years
T2 - The mesa study
AU - Rahsepar, Amir Ali
AU - Bluemke, David A.
AU - Habibi, Mohammadali
AU - Liu, Kiang
AU - Kawel-Boehm, Nadine
AU - Ambale-Venkatesh, Bharath
AU - Fernandes, Veronica R.S.
AU - Rosen, Boaz D.
AU - Lima, Joao A.C.
AU - Carr, James C.
N1 - Publisher Copyright:
© 2021 The Authors.
PY - 2021
Y1 - 2021
N2 - BACKGROUND: NT-proBNP (N-terminal pro-B-type natriuretic peptide) is widely used to diagnose and manage patients with heart failure. We aimed to investigate associations between NT-proBNP levels and development of global and regional myo-cardial impairment, dyssynchrony, and risk of developing myocardial scar over time. METHODS AND RESULTS: We included 2416 adults (45–84 years) without baseline clinical cardiovascular disease from MESA (Multi-Ethnic Study of Atherosclerosis). NT-proBNP was assessed at baseline (2000–2002). Cardiac magnetic resonance– measured left ventricular parameters were assessed at baseline and year 10 (2010–2012). Tagged cardiac magnetic resonance and myocardial dyssynchrony were assessed. We used linear and logistic regression models to study the relationships between quartiles of NT-proBNP levels and outcome variables. Left ventricular parameters decreased over time. After 10-year follow-up and adjusting for cardiovascular disease risk factors, people in the highest quartile had significantly greater decline in left ventricular ejection fraction (−1.60%; 95% CI, −2.26 to −0.94; P<0.01) and smaller decline in left ventricular end systolic volume index (−0.47 mL/m2; 95% CI, −1.18 to 0.23; P<0.01) compared with those in the lowest quartile. Individuals in the highest quartile had more severe risk factor adjusted global, mid, and apical regional dyssynchrony compared with those in the lowest, second, and third quartiles (all P-trend<0.05). Compared with the lowest-quartile group, the adjusted odds ratios for having myocardial scar was 1.3 (95% CI, 0.7–2.2) for quartile 2; 1.2 (95% CI, 0.6–2.3) for quartile 3; and 2.7 (95% CI, 1.4–5.5) for quartile 4 (P-trend=0.012) for the total sample. CONCLUSIONS: Among participants without baseline clinical cardiovascular disease, higher baseline NT-proBNP concentration was significantly associated with subclinical changes in developing myocardial dysfunction, more severe cardiac dyssyn-chrony, and higher odds of having myocardial scar over a 10-year period independent of traditional cardiovascular disease risk factors.
AB - BACKGROUND: NT-proBNP (N-terminal pro-B-type natriuretic peptide) is widely used to diagnose and manage patients with heart failure. We aimed to investigate associations between NT-proBNP levels and development of global and regional myo-cardial impairment, dyssynchrony, and risk of developing myocardial scar over time. METHODS AND RESULTS: We included 2416 adults (45–84 years) without baseline clinical cardiovascular disease from MESA (Multi-Ethnic Study of Atherosclerosis). NT-proBNP was assessed at baseline (2000–2002). Cardiac magnetic resonance– measured left ventricular parameters were assessed at baseline and year 10 (2010–2012). Tagged cardiac magnetic resonance and myocardial dyssynchrony were assessed. We used linear and logistic regression models to study the relationships between quartiles of NT-proBNP levels and outcome variables. Left ventricular parameters decreased over time. After 10-year follow-up and adjusting for cardiovascular disease risk factors, people in the highest quartile had significantly greater decline in left ventricular ejection fraction (−1.60%; 95% CI, −2.26 to −0.94; P<0.01) and smaller decline in left ventricular end systolic volume index (−0.47 mL/m2; 95% CI, −1.18 to 0.23; P<0.01) compared with those in the lowest quartile. Individuals in the highest quartile had more severe risk factor adjusted global, mid, and apical regional dyssynchrony compared with those in the lowest, second, and third quartiles (all P-trend<0.05). Compared with the lowest-quartile group, the adjusted odds ratios for having myocardial scar was 1.3 (95% CI, 0.7–2.2) for quartile 2; 1.2 (95% CI, 0.6–2.3) for quartile 3; and 2.7 (95% CI, 1.4–5.5) for quartile 4 (P-trend=0.012) for the total sample. CONCLUSIONS: Among participants without baseline clinical cardiovascular disease, higher baseline NT-proBNP concentration was significantly associated with subclinical changes in developing myocardial dysfunction, more severe cardiac dyssyn-chrony, and higher odds of having myocardial scar over a 10-year period independent of traditional cardiovascular disease risk factors.
KW - Cardiac magnetic resonance imaging
KW - Longitudinal study
KW - NT-proBNP
KW - Scar
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U2 - 10.1161/JAHA.120.019243
DO - 10.1161/JAHA.120.019243
M3 - Article
C2 - 33821688
AN - SCOPUS:85105140277
SN - 2047-9980
VL - 10
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 8
M1 - e019243
ER -