Utility of B-Type Natriuretic Peptide for Detecting Cardiac Involvement in Immunoglobulin Amyloidosis

Area of Science:

• Cardiology
• Biomarker Discovery
• Hematology

Background:

• Cardiac amyloidosis (CA) diagnosis in amyloid light-chain (AL) amyloidosis remains challenging due to the lack of established biomarkers.
• Early detection of CA is crucial for timely intervention and improved patient outcomes.

Purpose of the Study:

• To evaluate the diagnostic utility of various plasma biomarkers for detecting cardiac involvement in AL amyloidosis.
• To assess the prognostic value of these biomarkers regarding all-cause mortality.

Main Methods:

• Plasma levels of B-type natriuretic peptide (BNP), NT-proBNP, hs-cTnT, serum amyloid A, and dFLC were measured in AL amyloidosis patients with and without CA.
• Receiver operating characteristic (ROC) analysis was performed to determine the sensitivity and specificity of BNP for CA detection.
• Cox proportional hazard analysis was used to identify predictors of all-cause mortality.

Main Results:

• BNP levels were significantly higher in patients with CA compared to those without (1200.0 vs. 224.0 pg/mL, P = 0.001).
• BNP demonstrated a sensitivity of 83% and specificity of 70% for detecting CA (AUC = 0.75, P < 0.001).
• Other tested biomarkers (NT-proBNP, hs-cTnT, serum amyloid A, dFLC) were not effective in detecting CA. BNP was a significant predictor of all-cause mortality (HR = 3.266, P = 0.003).

Conclusions:

• BNP is a valuable biomarker for identifying cardiac involvement in AL amyloidosis patients.
• BNP serves as a significant predictor of prognosis and all-cause mortality in this patient population.