Clin Res Cardiol (2021) DOI DOI https://doi.org/10.1007/s00392-021-01843-w

MR-proADM is Associated with Advanced Grades of Heart Failure with Preserved Ejection Fraction

M. Natale1, M. Harbrücker1, U. Ansari1, T. Bertsch2, T. Roth3, S. Lindner1, S.-H. Kim1, J. Müller1, M. Borggrefe1, S. Lang1, U. Hoffmann1, I. Akin1, M. Behnes1

1I. Medizinische Klinik, Universitätsklinikum Mannheim, Mannheim; 2Institut für klinische Chemie und Laboratoriumsmedizin und Transfusionsmedizin, Klinikum Nürnberg Nord, Nürnberg; 3Zentrallabor, Universitätsklinikum Erlangen, Erlangen;

Purpose: Heart failure with preserved ejection fraction (HFpEF) affects half of all heart failure patients and shows an increasing prevalence. The accurate diagnosis of HFpEF is based on a complex echocardiographic algorithm. MR-proADM, a novel biomarker, might improve diagnostic capacity in heart failure patients. Therefore, this study aims to evaluate the association between MR-proADM levels and HFpEF assessed by echocardiography. Methods: Patients undergoing routine echocardiography were prospectively enrolled in the present monocentric study. Patients with left ventricular dysfunction (LVEF <50 %), right ventricular dysfunction (TAPSE < 17 mm) or moderate to severe valvular heart diseases were excluded. Blood samples for measurements of MR-proADM 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. MR-proADM levels and not NT-proBNP increased significantly according to decreasing grades of HFpEF (MR-proADM: p=0.017; NT-proBNP: p=0.38). Furthermore, MR-proADM correlated significantly with E/A (p=0.023) and E/E’ (p=0.041). In multivariable linear regression models adjusted for age, sex, creatinine, NT-proBNP, arterial hypertension, coronary artery disease and HFpEF, only HFpEF, NT-proBNP and creatinine sustained significantly associated with MR-proADM (HFpEF: Beta 0.13, T 2,22, p=0.03; NT-proBNP: Beta 0.389, T 6.63, p=0.0001). Both, MR-proADM and NT-proBNP were able to discriminate patients with HFpEF grade III (MR-proADM: AUC=0.697, p=0.04; NT-proBNP: AUC=0.798, p=0.002). In multivariable logistic regression models MR-proADM was still associated significantly with HFpEF grade III (MR-proADM: OR=3,540; p=0.084) after adjusting with age, sex, creatinine, arterial hypertension and coronary artery disease. Conclusions: This study demonstrates that MR-proADM adequately reflects HFpEF of advanced stages assessed by echocardiography and thus might be a useful biomarker for early detection of left ventricular diastolic dysfunction.

https://dgk.org/kongress_programme/jt2021/aP196.html