Highest Obesity Category Associated With Largest Decrease in N-Terminal Pro-B-Type Natriuretic Peptide in Patients...

Area of Science:

• Cardiology
• Metabolic Disorders
• Biomarkers

Background:

• Heart failure with preserved ejection fraction (HFpEF) is common in hospitalized patients, often linked to obesity.
• The behavior of natriuretic peptide levels in obese HFpEF patients is not well understood.

Purpose of the Study:

• To investigate NT-proBNP (N-terminal pro-B-type natriuretic peptide) level changes in HFpEF patients across different obesity categories.
• To evaluate the relationship between obesity, NT-proBNP levels, and clinical outcomes in hospitalized HFpEF patients.

Main Methods:

• 89 hospitalized HFpEF patients were categorized by BMI: nonobese (<30.0 kg/m²), obese (30.0-39.9 kg/m²), and severely obese (≥40.0 kg/m²).
• Changes in NT-proBNP levels during hospitalization and 1-year clinical outcomes were compared across obesity groups.
• Clinical characteristics were compared between patients with normal (≤125 pg/mL) and elevated NT-proBNP levels.

Main Results:

• Admission NT-proBNP levels were inversely related to BMI (severely obese: 770.5 pg/mL; obese: 1725 pg/mL; nonobese: 2607 pg/mL; P<0.01).
• Severely obese patients exhibited the largest NT-proBNP decrease with diuresis (-64.8%; P=0.03).
• 1-year survival was significantly higher in severely obese patients (95%) compared to obese (76%) and nonobese (63%) patients (P<0.01).

Conclusions:

• NT-proBNP levels are inversely associated with BMI in hospitalized HFpEF patients.
• The findings suggest NT-proBNP may require adjusted interpretation for diagnosis and treatment response assessment in obese HFpEF populations.
• Higher obesity was linked to better treatment response and improved survival in this cohort.