N-terminal pro-b-type natriuretic peptide, left ventricular mass, and incident heart failure

Eui Young Choi, Hossein Bahrami, Colin O. Wu, Philip Greenland, Mary Cushman, Lori B. Daniels, Andre L.C. Almeida, Kihei Yoneyama, Anders Opdahl, Aditya Jain, Michael H. Criqui, David Siscovick, Christine Darwin, Alan Maisel, David A. Bluemke, Joao A.C. Lima*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

49 Scopus citations

Abstract

Background-Elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP) is associated with clinically overt heart failure (HF). However, whether it provides additive prognostic information for incident HF beyond traditional risk factors and left ventricular (LV) mass index among multi-ethnic asymptomatic individuals has not yet been determined. We studied the associations of plasma NT-proBNP and magnetic resonance imaging defined LV mass index with incident HF in an asymptomatic multi-ethnic population. Methods and Results-A total of 5597 multi-ethnic participants without clinically apparent cardiovascular disease underwent baseline measurement of NT-proBNP and were followed for 5.5±1.1 years. Among them, 4163 also underwent baseline cardiac magnetic resonance imaging. During follow-up, 111 participants experienced incident HF. Higher NT-proBNP was significantly associated with incident HF, independent of baseline age, sex, ethnicity, systolic blood pressure, diabetes mellitus, smoking, estimated glomerular filtration rate, medications (anti-hypertensive and statin), LV mass index, and interim myocardial infarction (hazard ratio: 1.95 per 1U log NT-proBNP increment, 95% CI 1.54-2.46, P<0.001). This relationship held among different ethnic groups, non-Hispanic whites, African-Americans, and Hispanics. Most importantly, NT-proBNP provided additive prognostic value beyond both traditional risk factors and LV mass index for predicting incident HF (integrated discrimination index=0.046, P<0.001; net reclassification index; 6-year risk probability categorized by <3%, 3-10%, >10% =0.175, P=0.019; category-less net reclassification index=0.561, P<0.001). Conclusions-Plasma NT-proBNP provides incremental prognostic information beyond traditional risk factors and the magnetic resonance imaging-determined LV mass index for incident symptomatic HF in an asymptomatic multi-ethnic population.

Original languageEnglish (US)
Pages (from-to)727-734
Number of pages8
JournalCirculation: Heart Failure
Volume5
Issue number6
DOIs
StatePublished - Nov 2012

Keywords

  • Heart failure
  • Left ventricular mass
  • N-terminal pro-B-type natriuretic peptide

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'N-terminal pro-b-type natriuretic peptide, left ventricular mass, and incident heart failure'. Together they form a unique fingerprint.

Cite this