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Degree and distribution of left ventricular hypertrophy as a determining factor for elevated natriuretic peptide levels in patients with hypertrophic cardiomyopathy: insights from cardiac magnetic resonance imaging

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Abstract

Whether the left ventricular (LV) mass index (LVMI) and LV volumetric parameters are associated independently with natriuretic peptide levels is unclear in hypertrophic cardiomyopathy (HCM). Therefore, we investigated which parameters have an independent relationship with N-terminal pro-B type natriuretic peptide (NT-proBNP) levels in HCM patients using echocardiography and cardiac magnetic resonance imaging (CMR). A total of 103 patients with HCM (82 men, age 53 ± 12 years) were evaluated. Echocardiographic evaluations included left atrial volume index (LAVI) and early diastolic mitral inflow E velocity to early annular Ea velocity ratio (E/Ea). LVMI, maximal wall thickness and LV volumetric parameters were measured using CMR. The median value of NT-proBNP level was 387.0 pg/ml. The mean NT-proBNP level in patients with non-apical HCM (n = 69; 36 patients with asymmetric septal hypertrophy, 11 with diffuse, and 22 with mixed type) was significantly higher than in those with apical HCM (n = 34, P < 0.001). NT-proBNP level was negatively correlated with LV end-diastolic volume (LVEDV) (r = −0.263, P = 0.007) and positively with LVMI (r = 0.225, P = 0.022) and maximal wall thickness (r = 0.495, P < 0.001). Among the echocardiographic variables, LAVI (r = 0.492, P < 0.001) and E/Ea (r = 0.432, P < 0.001) were correlated with NT-proBNP. On multivariable analysis, non-apical HCM, increased maximal wall thickness and LAVI were independently related with NT-proBNP. Severity of LV hypertrophy and diastolic parameters might be important in the elevation of NT-proBNP level in HCM. Therefore, further evaluation of these parameters in HCM might be warranted.

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Acknowledgments

This study was supported by a grant of the Korea Healthcare technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (A085046).

Conflict of interest

None.

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Author notes

  1. Jeong Rang Park

    Present address: Division of Cardiology, Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, Republic of Korea

Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Jeong Rang Park, Jin-Oh Choi, Hye Jin Han, Sung-A Chang, Sung-Ji Park, Sang-Chol Lee, Seung Woo Park & Jae K. Oh

  2. Cardiovascular Imaging Center, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea

    Jeong Rang Park, Jin-Oh Choi, Hye Jin Han, Sung-A Chang, Sung-Ji Park, Sang-Chol Lee, Yeon Hyeon Choe, Seung Woo Park & Jae K. Oh

  3. Department of Radiology and Center of Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Yeon Hyeon Choe

  4. Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, MN, USA

    Jae K. Oh

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  1. Jeong Rang Park
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Correspondence to Jin-Oh Choi.

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Park, J.R., Choi, JO., Han, H.J. et al. Degree and distribution of left ventricular hypertrophy as a determining factor for elevated natriuretic peptide levels in patients with hypertrophic cardiomyopathy: insights from cardiac magnetic resonance imaging. Int J Cardiovasc Imaging 28, 763–772 (2012). https://doi.org/10.1007/s10554-011-9876-4

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  • DOI: https://doi.org/10.1007/s10554-011-9876-4

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