Degree and distribution of left ventricular hypertrophy as a determining factor for elevated natriuretic peptide levels in patients with hypertrophic cardiomyopathy: Insights from cardiac magnetic resonance imaging

Jeong Rang Park, Jin Oh Choi, Hye Jin Han, Sung A. Chang, Sung Ji Park, Sang Chol Lee, Yeon Hyeon Choe, Seung Woo Park, Jae K. Oh

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Whether the left ventricular (LV) mass index (LVMI) and LV volumetric parameters are associated independently with natriuretic peptide levels is unclear in hypertrophic cardiomyopathy (HCM). Therefore, we investigated which parameters have an independent relationship with N-terminal pro-B type natriuretic peptide (NT-proBNP) levels in HCM patients using echocardiography and cardiac magnetic resonance imaging (CMR). A total of 103 patients with HCM (82 men, age 53 ± 12 years) were evaluated. Echocardiographic evaluations included left atrial volume index (LAVI) and early diastolic mitral inflow E velocity to early annular Ea velocity ratio (E/Ea). LVMI, maximal wall thickness and LV volumetric parameters were measured using CMR. The median value of NT-proBNP level was 387.0 pg/ml. The mean NT-proBNP level in patients with non-apical HCM (n = 69; 36 patients with asymmetric septal hypertrophy, 11 with diffuse, and 22 with mixed type) was significantly higher than in those with apical HCM (n = 34, P<0.001). NT-proBNP level was negatively correlated with LV end-diastolic volume (LVEDV) (r = -0.263, P = 0.007) and positively with LVMI (r = 0.225, P = 0.022) and maximal wall thickness (r = 0.495, P<0.001). Among the echocardiographic variables, LAVI (r = 0.492, P<0.001) and E/Ea (r = 0.432, P<0.001) were correlated with NT-proBNP. On multivariable analysis, non-apical HCM, increased maximal wall thickness and LAVI were independently related with NT-proBNP. Severity of LV hypertrophy and diastolic parameters might be important in the elevation of NT-proBNP level in HCM. Therefore, further evaluation of these parameters in HCM might be warranted.

Original languageEnglish (US)
Pages (from-to)763-772
Number of pages10
JournalInternational Journal of Cardiovascular Imaging
Volume28
Issue number4
DOIs
StatePublished - Apr 1 2012

Keywords

  • Cardiac magnetic resonance imaging
  • Hypertrophic cardiomyopathy
  • N-terminal pro B-type natriuretic peptide

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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