Early Stages of Obesity-related Heart Failure Are Associated with Natriuretic Peptide Deficiency and an Overall Lack of Neurohormonal Activation: The Copenhagen Heart Failure Risk Study.
Glob Heart
; 15(1): 25, 2020 03 25.
Article
in En
| MEDLINE
| ID: mdl-32489798
ABSTRACT
Objective:
This study evaluated the associations between the natriuretic peptide activity and the neurohormonal response in non-obese and obese outpatients with and without heart failure (HF).Background:
Obesity-related HF may be a distinct subtype of HF. Obesity is associated with lower plasma concentrations of natriuretic peptides. The associations between obesity and neurohormonal activation estimated by mid-regional pro-adrenomedullin (MR-proADM) and copeptin in patients with HF is not elucidated.Methods:
This prospective cohort-study included 392 outpatients ≥60years, plus ≥1 risk-factor(-s) for HF (hypertension, ischemic heart disease, atrial fibrillation, diabetes, chronic kidney disease), and without known HF. Patients were categorized 'non-obese' BMI = 18.5-29.9 kg/m2 (n = 273) and 'obese' BMI ≥ 30 kg/m2 (n = 119). The diagnosis of HF required signs, symptoms, and abnormal echocardiography. NT-proBNP, MR-proANP, MR-proADM, and copeptin were analyzed.Results:
Obese patients were younger, had a higher prevalence of diabetes and chronic kidney disease, but a lower prevalence of atrial fibrillation. A total of 39 (14.3%) non-obese and 26 (21.8%) obese patients were diagnosed with HF. In obese patients, HF was not associated with higher plasma concentrations of NT-proBNP (Estimate 0.063; 95%CI -0.037-1.300; P = 0.064), MR-proANP (Estimate 0.207; 95%CI -0.101-0.515; P = 0.187), MR-proADM (Estimate 0.112; 95%CI -0.047-0.271; P = 0.168), or copeptin (Estimate 0.093; 95%CI -0.333-0.518; P = 0.669). Additionally, obese patients with HF had lower plasma concentrations of NT-proBNP (Estimate -0.998; 95%CI -1.778-0.218; P = 0.012), and MR-proANP (Estimate -0.488; 95%CI -0.845-0.132; P = 0.007) compared to non-obese patients with HF, whereas plasma concentrations of MR-proADM (Estimate 0.066; 95%CI -0.119-0.250; P = 0.484) and copeptin (Estimate 0.140; 95%CI -0.354-0.633; P = 0.578) were comparable.Conclusions:
Patients with obesity-related HF have natriuretic peptide deficiency and lack of increased plasma concentrations of MR-proADM and copeptin suggesting that patients with obesity-related HF have a blunted overall neurohormonal activity.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Peptide Fragments
/
Natriuretic Peptide, Brain
/
Adrenomedullin
/
Heart Failure
/
Obesity
Type of study:
Etiology_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Aged80
/
Female
/
Humans
/
Male
Country/Region as subject:
Europa
Language:
En
Journal:
Glob Heart
Year:
2020
Type:
Article
Affiliation country:
Denmark