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
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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. / Gaborit, Freja Stoltze; Kistorp, Caroline; Kümler, Thomas; Hassager, Christian; Tønder, Niels; Iversen, Kasper; Kamstru, Pia R.; Faber, Jens; Køber, Lars; Schou, Morten.
In: Global Heart, Vol. 15, No. 1, 25, 2020.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Early stages of obesity-related heart failure are associated with natriuretic peptide deficiency and an overall lack of neurohormonal activation
T2 - The Copenhagen heart failure risk study
AU - Gaborit, Freja Stoltze
AU - Kistorp, Caroline
AU - Kümler, Thomas
AU - Hassager, Christian
AU - Tønder, Niels
AU - Iversen, Kasper
AU - Kamstru, Pia R.
AU - Faber, Jens
AU - Køber, Lars
AU - Schou, Morten
PY - 2020
Y1 - 2020
N2 - 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.
AB - 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.
KW - Heart failure
KW - Natriuretic peptide
KW - Neurohormonal activation
KW - Obesity
U2 - 10.5334/GH.776
DO - 10.5334/GH.776
M3 - Journal article
C2 - 32489798
AN - SCOPUS:85085855073
VL - 15
JO - Global Heart
JF - Global Heart
SN - 2211-8160
IS - 1
M1 - 25
ER -
ID: 251583104