Clin Res Cardiol (2021). 10.1007/s00392-021-01933-9

MR-proANP reflects Right Ventricular Function assessed by Echocardiography

M. Harbrücker1, M. Natale1, S.-H. Kim1, S. Lindner1, S. Lang1, M. Borggrefe1, T. Roth2, T. Bertsch3, I. Akin1, M. Behnes1, für die Studiengruppe: CIBER

1I. Medizinische Klinik, Universitätsklinikum Mannheim, Mannheim; 2Institut für Experimentelle u. Klinische Pharmakologie, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen; 3Institut für klinische Chemie und Laboratoriumsmedizin und Transfusionsmedizin, Klinikum Nürnberg Nord, Nürnberg;

Purpose: The role of atrial MR-proANP in right heart failure has rarely beeninvestigated. This study aims to evaluate the association between MR-pro-ANPand right ventricular function (RVF) assessed by echocardiography. Methods: Patients undergoing routine echocardiography were prospectivelyenrolled in the present monocentric study. Patients with left ventriculardysfunction (LVEF <50 %) or moderate or severe aortic or mitral valvular heartdiseases were excluded. Blood samples for measurements of MR-proANP andNT-proBNP were collected at the day of echocardiographic examination.Subgroups of RVF based on tricuspid annular plane systolic excursion (TAPSE)were defined (I: TAPSE > 24 mm (n=23); II: TAPSE 18-24 mm (n=53); III:TAPSE < 18 (n=13)). Results: A total of 89 patients were included. Levels of MR-proANP as well asNT-proBNP increased significantly according to decreasing right ventricularfunction (MR-proANP: p=0.009, NT-proBNP: p=0.002). FurthermoreMR-proANP correlated significantly with TAPSE (p=0.009). Both, MR-proANPand NT-proBNP were able to discriminate patients with severe right ventriculardysfunction RVF of grade III (MR-proANP: AUC=0.767, p=0.002; NT-proBNP:AUC=0.805, p=0.0001). In multivariable logistic regression models onlyMR-proANP was still associated significantly with severe right ventriculardysfunction RVF of grade III (MR-proANP: OR=0.995, p=0.002) after adjustingwith age, sex, creatinine and NT-proBNP. Conclusions: Atrial MR-proANP adequately reflects RVF assessed byechocardiography and become a useful marker for detecting right heart failure atearly stages.

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