Patients with HFrEF who experienced decreasing BNP levels over one year demonstrated favorable long-term left ventricular remodeling, including improved LVIDs (p=0.001), LVIDd (p=0.006), and LVEF (p=0.008), compared to those with rising BNP.
Cohort (n=887)
No
Does a decrease in BNP levels over one year correlate with improved left ventricular remodeling and survival in patients with HFrEF?
In patients with HFrEF, a reduction in BNP levels over one year is associated with favorable long-term left ventricular reverse remodeling and improved survival.
p-value: p=0.001
Background B-type natriuretic peptide (BNP) is an important biomarker in heart failure with reduced ejection fraction (HFrEF). We aimed to explore changes in BNP and their relationship with long-term dynamics of left ventricular (LV) geometry. Methods This was a single-center retrospective cohort. Inclusion criteria included LV ejection fraction (LVEF) 40% measured by echocardiography, BNP ≥100 pg/mL at baseline, and a subsequent BNP measure within a year. Percent BNP change from baseline was computed and divided into tertiles. Percent change tertiles represented decreasing (min—max, −63.3 to −10.4), minimal changes (−10.4 to 2.8), and rising BNP levels (2.9 to 12.6). The study endpoint included LV internal dimension at end-systole (LVIDs), LV internal dimension at end-diastole (LVIDd), and LVEF. The secondary endpoint consisted of all-cause mortality. Results A total of 887 patients were included. Baseline characteristics, including age, sex, blood pressure, atrial fibrillation, baseline BNP, and LVEF, varied among tertiles ( p 0.05). When comparing to the rising BNP tertile, the decreasing BNP tertile showed decreased trends of LVIDs ( p = 0.001), LVIDd ( p = 0.006); and increased trends of LVEF ( p = 0.008). All-cause mortality was higher in the rising BNP tertile ( p 0.05) compared to the decreasing tertile. Conclusion In a real-world routine HFrEF cohort, this study demonstrates the time-dependent relationship between BNP changes, LV remodeling dynamics, and survival outcomes. Findings contribute to the literature supporting BNP as a dynamic marker for LV remodeling.
Romero et al. (Thu,) conducted a cohort in Heart failure with reduced ejection fraction (HFrEF) (n=887). Decreasing BNP levels over one year vs. Rising BNP levels was evaluated on Left ventricular remodeling (LVIDs, LVIDd, and LVEF trajectories) (p=0.001). Patients with HFrEF who experienced decreasing BNP levels over one year demonstrated favorable long-term left ventricular remodeling, including improved LVIDs (p=0.001), LVIDd (p=0.006), and LVEF (p=0.008), compared to those with rising BNP.