Abstract 18479: The Level of Pre-discharge N-terminal Pro B-type Natriuretic Peptide and its Change During Hospitalization Can Predict Future Left Ventricular Functional Recovery in Acute De Novo Dilated Cardiomyopathy
Background: To investigate the usefulness of N-terminal pro B-type natriuretic peptide (NT-proBNP) in the prediction of left ventricular (LV) functional recovery in acute de novo heart failure (HF) patients with dilated cardiomyopathy (DCMP).
Methods: A total of 175 consecutive patients acute de novo DCMP and HF were divided into 2 groups; the recovered group (group 1, n=54, 54.3±18.5 years, 31 males) vs the non-recovered group (group 2, n=121, 60.5±15.1 years, 79 males). NT-proBNP was measured serially at admission, at discharge, at 3 months after discharge and compared.
Results: NT-proBNP was 5465.2±5389.6 pg/mL at admission, and the level of NT-proBNP was significantly reduced after HF management (1805.1±2568.4 pg/mL at discharge, 1027.5±1394.9 pg/mL at 3 months after discharge, p<0.001). The level of NT-proBNP at admission was not different between the groups (5251.7±4297.7 vs 5602.7±6013.4 pg/mL, p=ns). However, the level of NT-proBNP at discharge (844.3±630.6 vs 2459.5±3132.8 pg/mL, p<0.001) and at 3 months after discharge (360.5±296.0 vs 1495.3±1652.2 pg/mL, p<0.001) were significantly lower in group 1 than in group 2. The decrease of the level of NT-proBNP from admission to discharge was significantly greater in group 1 than in group 2 (4407.4±4115.6 vs 2817.0±4532.9 pg/mL, p=0.032). The area under the curve to predict LV functional recovery by Receiver Operating Characteristic curve analysis was 0.702 for NT-proBNP change at discharge, 0.247 for the level of NT-proBNP at discharge, and 0.137 for the level of NT-proBNP at 3 months after discharge. The decrease of NT-proBNP > 1633.5 pg/mL from admission to discharge could significantly predict future LV functional recovery (sensitivity: 74.5%, specificity: 66.7%).
Conclusion: The level of NT-proBNP at discharge, not at admission, and the changes of NT-proBNP at discharge were significant predictor of future LV functional recovery. The serial monitoring of NT-proBNP would be useful for predicting future outcomes in acute de novo HF patients with DCMP.
- © 2012 by American Heart Association, Inc.