The combination of serum Nt-proBNP ≥ 108.00 pg/mL and maximum wall thickness ≥ 17.30 mm demonstrated good diagnostic performance for detecting myocardial fibrosis in HCM patients, with an AUC of 0.80.
Cross-Sectional (n=119)
No
Can non-invasive markers (Nt-proBNP, CMR strain, LV hypertrophy) predict the presence of myocardial fibrosis (LGE) in HCM patients with preserved EF?
Serum Nt-proBNP combined with maximum wall thickness can help identify myocardial fibrosis in HCM patients with preserved EF.
Effect estimate: AUC 0.80 (95% CI 0.67-0.92)
Myocardial fibrosis assessed by late gadolinium enhancement (LGE) on cardiovascular magnetic resonance (CMR) is associated with cardiovascular outcomes in hypertrophic cardiomyopathy (HCM) patients, but little is known about the utility of non-invasive markers for detecting LGE. This study aims to explore the association between cardiac-specific biomarkers, CMR myocardial strain, left ventricular (LV) hypertrophy and LGE in HCM patients with preserved ejection fraction (EF) and investigate the predictive values of these indexes for LGE. We recruited 33 healthy volunteers and 86 HCM patients with preserved EF to undergo contrast-enhanced CMR examinations. In total, 48 of 86 HCM patients had the presence of LGE. The LGE-positive patients had significant higher serum high-sensitivity cardiac troponin I (hs-cTnI) and N-terminal pro b-type natriuretic peptide (Nt-proBNP) levels and lower global longitudinal (GLS) and circumferential (GCS) strains than the LGE-negative group. The LGE% was independently associated with the Nt-proBNP levels, GCS, LV end-diastolic maximum wall thickness (MWT) and beta-blocker treatment. In the receiver operating characteristic curve analysis, the combined parameters of Nt-proBNP ≥ 108.00 pg/mL and MWT ≥ 17.30 mm had good diagnostic performance for LGE, with a specificity of 81.25% and sensitivity of 70.00%. These data indicate that serum Nt-proBNP is a potential biomarker associated with LGE% and, combined with MWT, were useful for identifying myocardial fibrosis in HCM patients with preserved EF. Additionally, LV GCS may be a more sensitive indicator for reflecting the presence of myocardial fibrosis than GLS.
Li et al. (Mon,) conducted a cross-sectional in Hypertrophic cardiomyopathy with preserved ejection fraction (n=119). Nt-proBNP and maximum wall thickness (MWT) vs. LGE-negative patients was evaluated on Presence of late gadolinium enhancement (LGE) (AUC 0.80, 95% CI 0.67-0.92). The combination of serum Nt-proBNP ≥ 108.00 pg/mL and maximum wall thickness ≥ 17.30 mm demonstrated good diagnostic performance for detecting myocardial fibrosis in HCM patients, with an AUC of 0.80.