Abstract 3291: Calcitonin Gene-Related Peptide as a Neurohormonal Marker in Patients with Decompensated Heart Failure
Background: The role of Calcitonin gene-related peptide (CGRP) in congestive heart failure (CHF) is not well elucidated. When released, it is believed to exert positive inotropic effect and coronary and peripheral vasodilatation resulting in increased cardiac output and improved symptoms.
Hypothesis: We hypothesized that endogenous CGRP is a compensatory hormone that is upregulated over the course of the resolution of decompensated heart failure.
Objective: To compare admission and discharge CGRP levels in decompensated CHF and those with noncardiac diseases patients. We also compare the relationship between plasma brain natriuretic peptide (BNP) and CGRP levels in CHF group.
Method: We enrolled 16 patients admitted to the hospital with the primary diagnosis of decompensated heart failure (mean ejection fraction: 20 –25%) and 16 patients with no known cardiac abnormality based on objective findings. Plasma CGRP and BNP levels that were obtained at the time of admission and discharge were log transformed and then compared using the Student’s t-test. Pearson’s correlation coefficient was used to test the association between CGRP and BNP.
Result: In CHF group, CGRP was found to be significantly higher at the time of discharge when compared to admission (Mean ± SE; 95.77 ± 37.51 vs. 60.85 ± 25.53 pg/ml, p=0.007). Also, plasma BNP was significantly lower at the time of discharge when compared to admission (742.56 ± 186.26 vs. 1530.94 ± 403.26 pg/ml, p=0.0002). BNP correlated negatively with CGRP (p=0.03, r =−0.53) only at the time of admission. In non CHF group, there was no significant change in CGRP at discharge levels between admission and at discharge (129.38 ± 40.65, p=0.052).
Conclusion: The increase in CGRP in decompensated CHF patient during the course of hospitalization indicates that this compensatory hormone is upregulated. This effect is associated with decreased plasma BNP levels indicative of improved cardiac symptoms and cardiac function at the time of discharge.