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Sex Differences in Time-Dependent Changes in B-Type Natriuretic Peptide in Hypertrophic Cardiomyopathy

Nobuyuki Enzan1, Shouji Matsushima1, Tomomi Ide1

  • 1Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University Fukuoka Japan.

Circulation Reports
|October 27, 2021
PubMed

Insights

Female sex is linked to higher B-type natriuretic peptide (BNP) levels in hypertrophic cardiomyopathy (HCM) patients. These elevated BNP concentrations in women persist over time, irrespective of other clinical factors.

Area of Science:

  • Cardiology
  • Biomarkers
  • Sex Differences in Medicine

Background:

  • Female sex is associated with poorer prognosis in hypertrophic cardiomyopathy (HCM).
  • Plasma B-type natriuretic peptide (BNP) concentration is a key prognostic predictor in HCM.
  • The impact of sex on BNP levels in HCM patients is not well understood.

Purpose of the Study:

  • To investigate the association between female sex and B-type natriuretic peptide (BNP) concentrations in patients with hypertrophic cardiomyopathy (HCM).
  • To determine if sex influences BNP levels over a 2-year follow-up period in HCM patients.

Main Methods:

  • Analysis of patient records from the HCM national database (2009-2014).
  • Inclusion of 611 HCM patients with baseline and 2-year follow-up BNP measurements.
  • Statistical analysis to assess the relationship between sex and BNP concentrations, adjusting for clinical characteristics.

Main Results:

  • Female patients had significantly higher median BNP concentrations at baseline and 2-year follow-up compared to males (P<0.001 for both).
  • Female sex was independently associated with higher BNP levels at 2-year follow-up (coefficient 0.31; P<0.001).
  • Cubic spline analysis indicated higher BNP levels in females than males, particularly among those with high baseline BNP.

Conclusions:

  • Female sex is associated with elevated B-type natriuretic peptide (BNP) concentrations in hypertrophic cardiomyopathy (HCM) patients.
  • This association is independent of clinical characteristics and baseline BNP levels.
  • Sex-specific differences in BNP levels may have implications for risk stratification and management in HCM.

Keywords:
B-type natriuretic peptideHypertrophic cardiomyopathySex difference

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