Relationships between biomarkers and left ventricular filling pressures at rest and during exercise in patients after myocardial infarction

Mads J. Andersen, Mads Ersbøll, John Bro-Jeppesen, Jacob E. Møller, Christian Hassager, Lars Køber, Barry A. Borlaug, Jens P. Goetze, Finn Gustafsson

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Background Increased pulmonary capillary wedge pressure (PCWP) is an independent prognostic predictor after myocardial infarction (MI), but PCWP is difficult to assess noninvasively in subjects with preserved ejection fraction (EF). We hypothesized that biomarkers would provide information regarding PCWP at rest and during exercise in subjects with preserved EF after MI.

Methods and Results Seventy-four subjects with EF >45% and recent MI underwent right heart catheterization at rest and during a symptom-limited semisupine cycle exercise test with simultaneous echocardiography. Plasma samples were collected at rest for assessment of midregional pro-A-type natriuretic peptide (MR-proANP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), galectin-3 (Gal-3), copeptin, and midregional pro-adrenomedullin (MR-proADM). Plasma levels of MR-proANP and PCWP were associated at rest (r = 0.33; P =.002) and peak exercise (r = 0.35; P =.002) as well as with changes in PCWP (r = 0.26; P =.03). Plasma levels of NT-proBNP and PCWP were weakly associated at rest (r = 0.23; P =.03) and peak exercise (r = 0.28; P =.02) but not with changes in PCWP (r = 0.20; P =.09). In a multivariable analysis, plasma levels of MR-proANP remained associated with rest and exercise PCWP (P <.01), whereas NT-proBNP did not. Plasma levels of Gal-3, copeptin, and MR-proADM were not associated with PCWP at rest or peak exercise.

Conclusions In subjects recovering from an acute MI with preserved EF, plasma levels of natriuretic peptides, particularly MR-proANP, are associated with filling pressures at rest and during exercise.

Original languageEnglish (US)
Pages (from-to)959-967
Number of pages9
JournalJournal of Cardiac Failure
Volume20
Issue number12
DOIs
StatePublished - Dec 1 2014

Keywords

  • Acute myocardial infarction
  • biomarkers
  • exercise testing
  • hemodynamics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Andersen, M. J., Ersbøll, M., Bro-Jeppesen, J., Møller, J. E., Hassager, C., Køber, L., Borlaug, B. A., Goetze, J. P., & Gustafsson, F. (2014). Relationships between biomarkers and left ventricular filling pressures at rest and during exercise in patients after myocardial infarction. Journal of Cardiac Failure, 20(12), 959-967. https://doi.org/10.1016/j.cardfail.2014.09.012