Predictive value of NT-pro BNP after acute myocardial infarction: Relation with acute and chronic infarct size and myocardial function

• Published in: International journal of cardiology 2011-02, Vol.147 (1), p.118-123
• Main Authors: Mayr, Agnes, Mair, Johannes, Schocke, Michael, Klug, Gert, Pedarnig, Kathrin, Haubner, Bernhard Johannes, Nowosielski, Martha, Grubinger, Thomas, Pachinger, Otmar, Metzler, Bernhard
• Format: Article
• Language: English
• Subjects: Acute and chronic myocardial infarction; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Biomarkers - blood; Cardiac magnetic resonance; Cardiology. Vascular system; Cardiovascular; Chronic Disease; Coronary heart disease; Female; Follow-Up Studies; Heart; Humans; Infarct size; Magnetic Resonance Imaging, Cine - methods; Male; Medical sciences; Middle Aged; Myocardial Infarction - blood; Myocardial Infarction - pathology; Myocarditis. Cardiomyopathies; Myocardium - pathology; Natriuretic Peptide, Brain - blood; NT-pro BNP; Peptide Fragments - blood; Predictive Value of Tests
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2009.09.537

Abstract Aim of the study We sought to assess the relation of N-terminal brain natriuretic peptide (NT-pro BNP) determined on day 3 after onset of acute myocardial infarction (AMI) symptoms with acute and chronic infarct size and functional parameters assessed by cardiac magnetic resonance (CMR) imaging. Furthermore, we wanted to investigate its predictive value for recovery of myocardial function. Methods CMR was performed in 49 consecutive patients within 6 days and in a subgroup 4 ( n = 27) and 12 ( n = 22) months after first acute ST-elevation AMI and successful primary angioplasty. NT-pro BNP was measured in the subacute phase at 66 ± 8 h after onset of symptoms. Results Log-transformed NT-pro BNP (lgNT-pro BNP) significantly correlated with infarct size in % of left ventricular myocardial mass ( r = 0.59 to 0.64; p < 0.004), with ejection fraction (EF) ( r = − 0.49 to − 0.55; p < 0.004) as well as with segmental wall thickening (SWT, mm) ( r = 0.41 to − 0.52; p < 0.04) at any time of assessment. Multiple linear regression analysis revealed baseline EF and lgNT-pro BNP to predict global functional recovery. Patients with NT-pro BNP concentrations < the mean level of 1115 pg/ml significantly improved in EF and SWT (all p < 0.02) during the study period, whereas patients with NT-pro BNP > 1115 pg/ml did not show significant functional recovery (all p = NS). Conclusion NT-pro BNP on day 3 after admission correlates with acute and chronic infarct size and myocardial function after AMI. Global and regional myocardial function did not recover in patients with higher NT-pro BNP (> 1115 pg/ml) during subacute phase of AMI.