Key result
Cardiac biomarkers NT-proBNP and sST2 significantly correlated with left ventricular end-diastolic pressure (r=0.40 and r=0.47, respectively; p<0.0001) and improved diastolic dysfunction prediction.
Why the study?
Measurement of LVEDP during cardiac catheterization is the gold standard for diagnosing elevated LV filling pressure but is invasive, prompting investigation into non-invasive cardiac serum biomarkers.
Do cardiac serum biomarkers (natriuretic peptides and sST2) correlate with invasively measured LVEDP and improve the prediction of diastolic dysfunction?
Observational (n=110)
No
Do cardiac serum biomarkers (natriuretic peptides and sST2) correlate with invasively measured LVEDP and improve the prediction of diastolic dysfunction?
Effect estimate: r = 0.47 (95% CI 0.30-0.60)
p-value: p=< 0.0001
NT-proBNP and sST2 correlate with invasively measured LVEDP and significantly improve the echocardiographic prediction of diastolic dysfunction.
Elevated filling pressure of the left ventricle (LV) defines diastolic dysfunction. The gold standard for diagnosis is represented by the measurement of LV end-diastolic pressure (LVEDP) during cardiac catheterization, but it has the disadvantage of being an invasive procedure. This study aimed to investigate the correlation between LVEDP and cardiac serum biomarkers such as natriuretic peptides (mid-regional pro-atrial natriuretic peptide [MR-proANP], B-type natriuretic peptide [BNP], and N-terminal prohormone BNP [NT-proBNP]), soluble ST2 (sST2), galectin-3 and mid-regional pro-adrenomedullin (MR-proAMD). Consecutive patients hospitalized in a tertiary center and undergoing left cardiac catheterization were included in the study. Diastolic dysfunction was considered present if the end-expiratory LVEDP was ≥ 15 mmHg. Cardiac biomarkers were determined from pre-procedural peripheral venous blood samples. A total of 110 patients were included, of whom 76 (69.0%) were males, with a median age of 65 (55-71) years. Median LVEDP was 13.5 (8-19) mmHg and diastolic dysfunction was present in 50 (45.4%) of the patients. LVEDP correlated with BNP (p < 0.0001, r = 0.39 [0.20-0.53]), NT-proBNP (p < 0.0001, r = 0.40 [0.22-0.55]), MR-proANP (p = 0.001, r = 0.30 [0.11-0.46]), sST2 (p < 0.0001, r = 0.47 [0.30-0.60]), but not with MR-proAMD (p = 0.77) or galectin-3 (p = 0.76). In the final stepwise multivariable binary logistic regression model, diastolic dysfunction was predicted by NT-proBNP, mitral average E/e', sST2, atrial fibrillation, and left atrium reservoir strain. BNP, NT-proBNP, MR-proANP, and sST2 had predictive value for diastolic dysfunction. In contrast, galectin-3 and MR-proAMD were not associated with increased filling pressures. Furthermore, NT-proBNP and sST2 significantly improved diastolic dysfunction prediction in the final multivariable model.
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Călburean et al. (2024) conducted an observational in Diastolic dysfunction (n=110). Cardiac serum biomarkers (NT-proBNP, sST2, BNP, MR-proANP) was evaluated on Correlation between LVEDP and sST2 (r = 0.47, 95% CI 0.30-0.60, p=< 0.0001). Cardiac biomarkers NT-proBNP and sST2 significantly correlated with left ventricular end-diastolic pressure (r=0.40 and r=0.47, respectively; p<0.0001) and improved diastolic dysfunction prediction.
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