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

MR-proADM reflects Right Ventricular Function assessed by Echocardiography

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

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

Background: Appropriate assessment of right heart failure – often underestimated – is more regarded as a mere bystander and victim of pathological cardiovascular processes. However, the communicative role of right ventricular function between pulmonary and systemic circulation demands further investigation. MR-proADM, a novel biomarker, might aid early diagnosis of right heart failure and thus lead to better clinical outcomes. This study aims to evaluate the association between MR-proADM and right ventricular function (RVF) assessed by echocardiography. Methods: Patients undergoing routine echocardiography were prospectively enrolled in the present monocentric study. Patients with left ventricular dysfunction (LVEF <50 %) or moderate or severe aortic or mitral valvular heart diseases were excluded. Blood samples for measurements of MR-proADM and NT-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-proADM as well as NT-proBNP increased significantly according to decreasing right ventricular function (MR-proADM: p=0.007, NT-proBNP: p=0.002). Furthermore MR-proADM correlated significantly with TAPSE (p=0.0001). Both, MR-proADM and NT-proBNP were able to discriminate patients with severe right ventricular dysfunction RVF III (MR-proADM: AUC=0.745, p=0.005; NT-proBNP: AUC=0.805, p=0.0001). Even after multivariable adjustment in logistic regression models, MR-proADM was still associated with RVF of grade III (OR=0.130; p=0.002). Conclusions: This study demonstrates that MR-proADM is able to reflect RVF assessed by echocardiography and might thus be a useful marker for detecting right heart failure at early stages.

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