Prognostic Value Of Plasma NT-proBNP And MR-proANP In Patients With Heart Failure

BackgroundCardiovascular disease is caused by heart and vascular diseases,including coronary heart disease,hypertension,congenital heart disease,heart failure,and cardiomyopathy.It is not a single type of disease but a variety of conditions.Heart failure(HF)is referred to the failure of the systolic and diastolic dysfunction of the heart to adequately drain the venous return to the heart,resulting in venous blood stasis and insufficient blood perfusion in the arterial system.This leads to cardiac circulation disorder syndrome.Heart failure is not an independent disease,but an end stage of the development of heart disease.MR-proANP(midregional pro-atrial natriuretic peptide)is the middle part of atrial natriuretic peptide precursor,with high stability and long half-life.Multiple clinical experiments have confirmed that its value in diagnosing heart failure and judging the prognosis of heart failure is better than B-type natriuretic peptide(BNP)and NT-proBNP(N-terminal pro-brain natriuretic peptide),the purpose of our experiment is to explore the clinical applicability of MR-proANP in the diagnosis of heart failure.MethodsFrom January 2017 to December 2018 patients with heart failure in the Department of Cardiovascular Medicine of the Second Hospital of Shandong University were selected continuously.All patients were diagnosed using the European Society of Cardiology's 2012 Guidelines for Heart Failure[19],and were graded according to the New York Heart Association(NYHA)classification.For the control group,healthy volunteers matching age and gender of the heart failure group were selected from the health examination center of the Second Hospital of Shandong University.Height,weight,waist circumference,blood glucose,LVEF,and BNP were measured in both groups.MR-proANP and NT-proBNP concentrations were detected by enzyme-linked immunosorbent assays.Correlations between several biomarkers and heart failure were explored with Spearman correlation analysis.Logistic regressions of biomarkers were performed to investigate risk factors for heart failure.The diagnostic performance of several biomarkers were evaluated with receiver operating characteristic curves.ResultsMR-proANP(r=0.603),NT-proBNP(r=0.398),and BNP(r=0.456)were all associated with severity of heart failure.The MR-proANP and age were identified as independent prognostic factors for heart failure in multiple logistic regression analysis(P?0.05).For the identification of early and late heart failure,MR-proANP was more accurate than BNP and NT-proBNP(AUC=0.75 8 of BNP;AUC=0.829 of MR-proANP;AUC=0.686 of NT-proBNP,P?0.05).In addition,when analyzed by the variables of serum creatinine<84mmol/L,age<60 years,BMI?28 or female sex,the accuracy of MR-proANP was comparable with BNP in diagnosing heart failure(AUC of MR-proANP vs BNP,P>0.05).ConclusionMR-proANP has better diagnostic value than NT-proBNP.Moreover,MR-proANP has advantages in the identification of early and late heart failure.When analyzed by variables including Scr?88mmol/L,age less than 60 years,BMI?28,female sex,we found that MR-proANP has equal diagnostic value with BNP in the diagnosis of heart failure.It is also not susceptible to some factors such as kidney function,age,gender and obesity and the higher stability makes MR-proANP a valuable prognostic factor for heart failure.