Journal Article

Comparable prognostic impact of BNP levels among HFpEF, Borderline HFpEF and HFrEF: a report from the CHART-2 Study

Nochioka, Kotaro, Sakata, Yasuhiko, Kasahara, Shintaro, Onose, Takeo, Oikawa, Takuya, Aoyanagi, Hajime, Miyata, Satoshi, Abe, Ruri, Shimokawa, Hiroaki, Takahashi, Jun, Tsuji, Kanako, Miura, Masanobu, Shiroto, Takashi, Yamauchi, Takeshi, Sato, Masayuki

2018

Overview

We aimed to compare the usefulness of plasma levels of B-type natriuretic peptide (BNP) for long-term risk stratification among patients with heart failure (HF) with preserved left ventricular ejection fraction (LVEF) (HFpEF), borderline HFpEF, and HF with reduced LVEF (HFrEF) in the same HF cohort. In the CHART-2 Study ( N  = 10,219), we categorized 4301 consecutive Stage C/D HF patients (mean age 68.7 years, female 32.4%) into 3 groups: HFpEF (LVEF ≥ 50%, N  = 2893), borderline HFpEF (LVEF 40–50%, N  = 666), and HFrEF (LVEF ≤ 40%, N  = 742). During the median 6.3-year follow-up, all-cause deaths occurred in 887 HFpEF, 330 borderline HFpEF, and 330 HFrEF patients. Although median BNP levels increased from HFpEF, borderline HFpEF to HFrEF (85.3, 126 and 208 pg/ml, respectively, P  < 0.001), the relationship between log 2 BNP levels and the mortality risk was comparable among the 3 groups. As compared with patients with BNP < 30 pg/ml, those with 30–99, 100–299 and ≥ 300 pg/ml had comparably increasing mortality risk among the 3 groups (hazard ratio 2.5, 4.7 and 7.8 in HFpEF, 2.1, 4.2 and 7.0 in borderline HFpEF, and 3.0, 4.7 and 9.5 in HFrEF, respectively, all P  < 0.001). BNP levels have comparable prognostic impact among HFpEF, borderline HFpEF, and HFrEF patients.

• Publisher: Springer Japan,Springer Nature B.V
• Subject: Age / Aged / Biomarkers / Biomarkers - blood / Biomedical Engineering and Bioengineering / Body mass index / Brain natriuretic peptide / Cardiac Surgery / Cardiology / Cardiomyopathy / Cardiovascular disease / Cause of Death - trends / Charts / Cohort analysis / Congestive heart failure / Ejection fraction / Failure analysis / Female / Females / Follow-Up Studies / Health risks / Heart diseases / Heart failure / Heart Failure - blood / Heart Failure - epidemiology / Heart Failure - physiopathology / Hemoglobin / Humans / Hypertension / Incidence / Japan - epidemiology / Male / Medical prognosis / Medicine / Medicine & Public Health / Mortality / Mortality risk / Natriuretic Peptide, Brain - blood / Older people / Original Article / Pandemics / Patients / Peptides / Plasma levels / Prognosis / Prospective Studies / Risk / Risk Assessment - methods / Risk Factors / Software / Stroke Volume - physiology / Vascular Surgery / Ventricle / Ventricular Function, Left - physiology