Role of natriuretic peptide to predict cardiac abnormalities in patients with hereditary transthyretin amyloidosis.: Cardiac biomarkers in FAP

Thibaud Damy 1, * Jean-François Deux 2, 3, 4 Stéphane Moutereau 2, 5 Soulef Guendouz 2, 3 Dania Mohty 6 Stéphane Rappeneau 2, 3 Aziz Guellich 3 Luc Hittinger 7 Sylvain Loric 8 Jean-Pascal Lefaucheur 2, 3, 9 Violaine Plante-Bordeneuve 3, 10, 11
* Auteur correspondant
1 INSERM U955, équipe 8
CIC - CHU Henri Mondor, Service de Cardiologie [Mondor], Réseau AMYLOSE Mondorien, IMRB - Institut Mondor de Recherche Biomédicale
7 INSERM U955, équipe 3
Réseau AMYLOSE Mondorien, IMRB - Institut Mondor de Recherche Biomédicale
8 INSERM U955, équipe 7
Departement de Biochimie-Pharmacotoxicologie, IMRB - Institut Mondor de Recherche Biomédicale
Abstract : BACKGROUND: Familial amyloid polyneuropathy (FAP) mainly targets the peripheral nervous system and heart. Early noninvasive detection of cardiac impairment is critical for therapeutic management. AIM: To assess if amino-terminal pro-brain natriuretic peptide (NT-proBNP) or troponin T (cTnT) can predict echocardiographic left-ventricle (LV) impairment in FAP. METHODS: Thirty-six asymptomatic carriers and patients with FAP had echocardiographic measurement of left-ventricular (LV) systolic function, hypertrophy (LVH) and estimation of filling pressure (FP). RESULTS: Overall, median age, NT-proBNP, and LV ejection fraction were, respectively, 59 years (41-74), 323 pg/ml (58-1960), and 60% (51-66). Twelve patients had increased cTnT. Prevalence of ATTR gene mutations was 53% for Val30Met. Four individuals were asymptomatic, 6 patients had isolated neurological clinical signs, and 26 had echo-LV abnormalities. The ROC curve identified NT-proBNP patients with echo-LV abnormalities (area: 0.92; (0.83-0.99), p = 0.001) at a threshold >82 pg/ml with a sensitivity of 92%, and a specificity of 90%. Increased in NT-proBNP occurred in patients with SD and/or LVH with or without increase in FP. Elevated cTnT (>0.01 ng/ml) was only observed in patients with LVH and systolic dysfunction, with or without FP. CONCLUSION: In FAP, NT-proBNP was associated with cardiac impairment suggesting that NT-proBNP could be used in carriers or in FAP patients with only neurologic symptoms for identifying the appropriate time to start cardiac echocardiographic assessment and follow-up. cTnT identified patients with severe cardiac disease.
Type de document :
Article dans une revue
Amyloid: The Journal of Protein Folding Disorders, Taylor & Francis, 2013, 20 (4), pp.212-20. 〈10.3109/13506129.2013.825240〉
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Soumis le : mardi 12 août 2014 - 16:18:46
Dernière modification le : mercredi 29 novembre 2017 - 09:31:09
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Thibaud Damy, Jean-François Deux, Stéphane Moutereau, Soulef Guendouz, Dania Mohty, et al.. Role of natriuretic peptide to predict cardiac abnormalities in patients with hereditary transthyretin amyloidosis.: Cardiac biomarkers in FAP. Amyloid: The Journal of Protein Folding Disorders, Taylor & Francis, 2013, 20 (4), pp.212-20. 〈10.3109/13506129.2013.825240〉. 〈inserm-00856266〉

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