Proenkephalin and prognosis in heart failure with preserved ejection fraction: a GREAT network study

Fig. 1. PENK relationship to the echocardiographic diastolic index E/e′. Correlation of PENK with echocardiographic index of diastolic dysfunction E/e′. The Spearman correlation coefficient was 0.453 (p < 0.0005)

Fig. 2. MRI-derived ventricular volumes according to PENK tertiles. Box and whisker plots of a LAEDVI and b LAESVI according to PENK tertiles. LAEDVI and LAESVI differed between PENK tertiles (ANOVA p = 0.024 and 0.01). Significant differences were seen between the second and first tertile of LAEDVI (p = 0.025) and between second and third tertiles of LAESVI and the first tertile (p = 0.016 and 0.042, respectively)

Fig. 3. Hazard ratios for PENK in Cox survival analysis for Death/HF or Death at 2 years in HFpEF and HFrEF. Forest plots showing hazard ratios and confidence intervals for PENK (as a univariable in A) following adjustment for a multivariable base model (B, containing the variables age, gender, NYHA class IV, past history of heart failure, ischemic heart disease, hypertension, diabetes, atrial fibrillation, systolic BP, heart rate, plasma urea, creatinine, sodium, haemoglobin, natriuretic peptide), base model with troponin (C), and base model with troponin and BMI (D). Hazard ratios for interaction of PENK with ejection fraction status are shown on the right of the figure

Fig. 4. Kaplan–Meier survival analysis for death/HF hospitalisation and all-cause mortality. Kaplan–Meier plots of a the composite endpoint of death and/or HF hospitalization and b all-cause mortality, according to PENK tertiles. Log rank tests showed differences between tertiles 1 and 3 (p < 0.0005 for both endpoints), and between tertiles 2 and 3 (p = 0.006 for death/HF and p < 0.0005 for death)