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Platelet Function Analyzer 100 and Brain Natriuretic Peptide as Biomarkers in Obstructive Hypertrophic Cardiomyopathy

Joseph L Blackshear1, Robert E Safford1, Colleen S Thomas2

  • 1Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic Florida, Jacksonville, Florida.

The American Journal of Cardiology
|February 5, 2018
PubMed

Insights

Dual blood biomarkers, platelet function analyzer (PFA) and B-type natriuretic peptide (BNP), show high accuracy for hypertrophic cardiomyopathy (HC) screening. PFA and BNP combined offer superior sensitivity and specificity compared to electrocardiogram (ECG) for obstructive HC detection.

Area of Science:

  • Cardiology
  • Biomarker Discovery
  • Genetic Cardiology

Background:

  • Hypertrophic cardiomyopathy (HC) is a significant cause of heart disease.
  • Current screening methods like electrocardiogram (ECG) have limitations in sensitivity and specificity.
  • There is a need for more effective screening tools for early detection of HC.

Purpose of the Study:

  • To evaluate the efficacy of dual blood biomarkers, platelet function analyzer (PFA)-100 and normalized B-type natriuretic peptide (BNP/ULN), for hypertrophic cardiomyopathy (HC) screening.
  • To compare the diagnostic performance of these biomarkers against the electrocardiogram (ECG).

Main Methods:

  • Measured PFA-100 and BNP/ULN in patients with HC and normal controls (NCs).
  • Derived estimated PFA from a regression equation with PFA and gradient.
  • Calculated sensitivity and specificity of single and dual biomarkers (PFA × BNP/ULN) compared to ECG in various HC classifications (obstructive, latent, nonobstructive).

Main Results:

  • The product of PFA × BNP/ULN showed near-complete separation of values between obstructive HC patients and NCs.
  • Estimated PFA × BNP/ULN achieved 93% sensitivity and 100% specificity for class I obstructive HC, significantly outperforming ECG (71% sensitivity).
  • BNP/ULN was elevated in HC patients regardless of mutation status or family history, indicating no specific elevation based on these factors.

Conclusions:

  • Platelet function analyzer (PFA) and B-type natriuretic peptide (BNP) are strongly associated with obstructive hypertrophic cardiomyopathy (HC) and show potential for screening.
  • The combined use of PFA and BNP/ULN demonstrates superior diagnostic accuracy compared to ECG for HC screening, particularly in obstructive forms.
  • BNP levels are not uniquely elevated in familial or mutation-positive HC, suggesting its utility is primarily in assessing cardiac strain rather than genetic predisposition.

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