Abstract 230 MR-proANP is Associated with Heart Failure with Preserved Ejection Fraction assessed by Echocardiography

Clin Res Cardiol (2021). 10.1007/s00392-021-01933-9
MR-proANP is Associated with Heart Failure with Preserved Ejection Fraction assessed by Echocardiography
M. Harbrücker¹, M. Natale¹, S.-H. Kim¹, S. Lindner¹, S. Lang¹, M. Borggrefe¹, U. Hoffmann¹, T. Roth¹, T. Bertsch², I. Akin¹, M. Behnes¹, für die Studiengruppe: CIBER
¹I. Medizinische Klinik, Universitätsklinikum Mannheim, Mannheim; ²Institut für klinische Chemie und Laboratoriumsmedizin und Transfusionsmedizin, Klinikum Nürnberg Nord, Nürnberg;
Purpose: Half of all heart failure patients suffer from heart failure with a preserved ejection fraction (HFpEF). The accurate diagnosis of HFpEF is based on acomplex echocardiographic algorithm. Novel biomarkers, such as MR-pro ANP, might improve diagnostic capacity in heart failure patients. Therefore, this studyaims to evaluate the association between MR-proANP levels and HFpEF assessed by echocardiography. Methods: Patients undergoing routine echocardiography were prospectively enrolled in the present monocentric study. Patients with left ventriculardysfunction (LVEF <50 %), right ventricular dysfunction (TAPSE < 17 mm) or moderate to severe valvular heart diseases were excluded. Blood samples for measurements of MR-proANP and NT-proBNP were collected at the day of echocardiographic examination. Subgroups based on HFpEF grades were defined (no HFpEF (n=14); grade I (n=14); grade II (n=29); grade III (n=11)). Results: A total of 68 patients were included. Levels of MR-proANP and NT-proBNP increased significantly alongside to decreasing stages of HFpEF(MR-proANP: p=0.034; NT-proBNP: p=0.009). Furthermore, MR-proANPcorrelated significantly with E/E’ (p=0.003). Both, MR-proANP and NT-proBNP were able to discriminate patients with severe HFpEF grade III (MR-proANP:AUC=0.73, p=0.016; NT-proBNP: AUC=0.81, p=0.001). In multivariable logistic regression models MR-proANP was associated significantly with HFpEF grade III(MR-proANP: OR=8.571; p=0.003) after adjusting with age, sex, creatinine,NT-proBNP, arterial hypertension and coronary artery disease. Conclusions: This study demonstrates that MR-proANP is able to reflect HFpEF stages assessed by echocardiography. It may thus serve as a useful biomarker forearly detection of HFpEF.
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