Prognostic value of N-terminal pro C-type natriuretic peptide in heart failure patients with preserved and reduced

Related Experiment Video

Updated: Apr 26, 2026

Integration of Brain Tissue Saturation Monitoring in Cardiopulmonary Exercise Testing in Patients with Heart Failure
04:20

Integration of Brain Tissue Saturation Monitoring in Cardiopulmonary Exercise Testing in Patients with Heart Failure

Published on: October 1, 2019

5.1K

Dirk J Lok1, Ijsbrand T Klip, Adriaan A Voors

  • 1University Medical Center Groningen, Groningen, The Netherlands; Deventer Hospital, Deventer, The Netherlands.

European Journal of Heart Failure
|August 2, 2014
PubMed

Insights

N-terminal pro C-type natriuretic peptide (NT-proCNP) predicts outcomes in heart failure with preserved ejection fraction (HFpEF) but not in heart failure with reduced ejection fraction (HFrEF). This finding offers new insights into HFpEF prognosis.

Area of Science:

  • Cardiology
  • Biomarkers
  • Heart Failure Research

Background:

  • Natriuretic peptides (NPs) like A-type and B-type are established heart failure (HF) biomarkers.
  • C-type natriuretic peptide (CNP) is primarily localized in the endothelium, and its prognostic role in HF is unclear.
  • The N-terminal part of pro CNP (NT-proCNP) has not been fully evaluated for its prognostic significance in chronic HF.

Purpose of the Study:

  • To investigate the prognostic power of NT-proCNP in patients with chronic heart failure.
  • To identify clinical correlates of NT-proCNP levels in this patient population.
  • To determine if NT-proCNP has differential prognostic value in heart failure with preserved ejection fraction (HFpEF) versus heart failure with reduced ejection fraction (HFrEF).

Main Methods:

  • A cohort of 567 hospitalized heart failure patients had NT-proCNP levels measured at discharge.
  • The primary endpoint was a composite of all-cause mortality and HF hospitalization over 18 months.
  • Multivariate regression analyses and reclassification methods were used to assess NT-proCNP's predictive value, considering ejection fraction subtypes (HFpEF vs. HFrEF).

Main Results:

  • NT-proCNP levels correlated positively with NT-proBNP and renal function parameters, and negatively with female sex and VEGF.
  • In multivariate analysis, NT-proCNP was a strong independent predictor of the primary endpoint in HFpEF (HR 1.78, P=0.006) but not in HFrEF (HR 1.07, P=0.616).
  • NT-proCNP demonstrated significant additive prognostic value in HFpEF (P < 0.001) but not in HFrEF (P = 0.453).

Conclusions:

  • NT-proCNP serves as a potent independent prognostic marker for adverse outcomes specifically in patients with HFpEF.
  • The prognostic utility of NT-proCNP does not extend to patients with HFrEF.
  • These findings highlight the potential role of NT-proCNP in risk stratification for HFpEF patients.
Abstract

Keywords:
Chronic heart failureHFpEFNT-proCNPNatriuretic peptidesPrognosis

More Related Videos

Functional Assessment of the Donor Heart During Ex Situ Perfusion: Insights from Pressure-Volume Loops and Surface Echocardiography08:21

Functional Assessment of the Donor Heart During Ex Situ Perfusion: Insights from Pressure-Volume Loops and Surface Echocardiography

Published on: October 11, 2022

2.4K
Evaluation of Right Ventricular Function in Experimental Models of Pulmonary Arterial Hypertension10:03

Evaluation of Right Ventricular Function in Experimental Models of Pulmonary Arterial Hypertension

Published on: June 27, 2025

951

Related Concept Videos

Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers01:19

Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers

Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
750
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
1.7K
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
1.7K
Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
4.6K
Heart Failure VII: Nursing Interventions01:30

Heart Failure VII: Nursing Interventions

The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
782
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
621