Prognostic Value of B-Type Natriuretic Peptide Level in Patients With Heart Failure With a Higher Left Ventricular...

Area of Science:

• Cardiology
• Biomarkers
• Heart Failure Research

Background:

• Assessing B-type natriuretic peptide (BNP) levels in heart failure (HF) patients with higher left ventricular ejection fraction (LVEF) requires further investigation.
• Previous findings suggest a worse prognosis in HF patients with higher LVEF, prompting a hypothesis that BNP levels might correlate with LVEF in this population.

Purpose of the Study:

• To investigate the relationship between BNP levels and LVEF in patients with HF and LVEF >40%.
• To determine if BNP levels can predict event-free survival independently of LVEF, E/e', and atrial fibrillation (AF) in this patient group.

Main Methods:

• A prospective, observational, multicenter cohort study included 231 HF patients with LVEF >40% at hospital discharge.
• Collected data included LVEF, E/e', BNP levels, and electrocardiogram-confirmed concurrent AF.
• Patients were categorized into HF with mildly reduced EF (HFmrEF) and different subgroups of HF with preserved EF (HFpEF) based on LVEF thresholds (≥50% and <60%, and ≥60%).

Main Results:

• BNP levels did not significantly differ among the HFmrEF, HFpEF (≥50% and <60%), and HFpEF (≥60%) groups.
• A BNP level of ≥377 pg/mL was a significant differentiator for event-free survival (P<0.001).
• Multivariate Cox proportional hazards analysis revealed that BNP levels were significantly associated with event-free survival, independent of LVEF, E/e', and concurrent AF.

Conclusions:

• Higher BNP levels are significantly and independently associated with event-free survival in HF patients with LVEF >40%.
• The predictive value of BNP for event-free survival is independent of LVEF, E/e', and concurrent AF in this cohort.