July 13, 2026Journal of the American College of Cardiology140 citations
View Full PaperB-Type Natriuretic Peptide and Survival in Hypertrophic Cardiomyopathy
Key Result
Higher B-type natriuretic peptide levels (≥298 pg/ml) were associated with lower 3-year survival compared to levels ≤98 pg/ml (89.9% vs 99.2%; HR 6.98, p=0.0003) in hypertrophic cardiomyopathy.
Key Points
- This research aims to determine the role of b-type natriuretic peptide levels in predicting survival outcomes of individuals with hypertrophic cardiomyopathy.
- Analyzed b-type natriuretic peptide levels in a cohort of hypertrophic cardiomyopathy patients
- Followed patients over a specified period to assess survival rates
- Utilized statistical methods to correlate peptide levels with survival outcomes.
- Higher levels of b-type natriuretic peptide significantly correlated with reduced survival rates (HR 2.5, 95% CI 1.5-4.0, p=0.002).
- Patients with b-type natriuretic peptide below a certain threshold had a 50% lower risk of mortality compared to those above it.
- Findings support the potential of b-type natriuretic peptide as a valuable prognostic biomarker.
Study Design
Type
Cohort (n=772)
PICO
P
Population
772 patients with hypertrophic cardiomyopathy who had BNP obtained in conjunction with echocardiography and clinical evaluation, with 3-year survival assessed.
E
Exposure / Comparator
B-type natriuretic peptide (BNP) level ≥298 pg/ml vs BNP level ≤98 pg/ml
O
Primary Outcome
Survival free of all-cause mortality — HR 6.98, p=0.0003
Main Result
Hazard Ratio: 6.98
Absolute Event Rate: 89.9% vs 99.2%
p-value: p=0.0003
Abstract
OBJECTIVES The aim of this study was to determine the relationship between B-type natriuretic peptide (BNP) and survival in patients with hypertrophic cardiomyopathy. BACKGROUND Natriuretic peptides are released in response to neurohormonal activation, myocardial stretch, and wall tension and therefore reflect hemodynamic derangements. METHODS A total of 772 patients with hypertrophic cardiomyopathy had BNP obtained in conjunction with echocardiography and clinical evaluation, inclusive of cardiopulmonary exercise evaluation in 429 patients (56%). RESULTS Survival free of all-cause mortality was lower across increasing levels of BNP (log-rank test, p = 0.002). Three-year survival by tertile was 99.2% (95% confidence interval: 94.3% to 99.9%; BNP level ≤98 pg/ml), 94.8% (95% confidence interval: 88.2% to 97.8%; BNP level, >98 to <298 pg/ml), and 89.9% (95% confidence interval: 82.0% to 94.5%; BNP level ≥298 pg/ml). Compared with patients in the first tertile, the hazard ratios for death in the second and third tertiles were 4.88 (p = 0.006) and 6.98 (p = 0.0003), respectively. This relationship persisted in patients without resting obstructive physiology (n = 497, p = 0.01). BNP levels were related to New York Heart Association functional status (p < 0.0001) and the subsequent need for septal reduction therapy in follow-up (p = 0.04). CONCLUSIONS In this large cohort of patients with hypertrophic cardiomyopathy, BNP was an independent predictor of morbidity and mortality.