Abstract 21198: Human Atrial Natriuretic Peptide Levels in Combination With Plasma Brain Natriuretic Peptide Levels Predict Cardiac Function in Patients With Light-Chain Amyloidosis

Abstract

Introduction: Plasma brain natriuretic peptide (BNP) levels are known to be a predictor of cardiac dysfunction in patients with systemic light-chain amyloidosis (AL). There is no data about the clinical significance of human atrial natriuretic peptide (h-ANP) levels in combination with BNP. Hypothesis: Plasma h-ANP levels in combination with plasma BNP levels provide additional information about the cardiac function in patients with AL. Methods: We prospectively examined 100 consecutive, untreated patients with biopsy-proven systemic AL amyloidosis with data of BNP and h-ANP. Patients were divided into 4 groups by h-ANP (median value, 29pg/mL) and BNP (median value, 68pg/mL) levels. We assessed diastolic wall strain (DWS) calculated from M-mode in left ventricular (LV) posterior wall (PW) as the following equation {(LVPWs - LVPWd)/LVPWs} (s, at end-systole; d, at end-diastole), standard 2-dimensional echocardiography, Doppler flow measurements, and LV global longitudinal strain (GLS) by speckle tracking echocardiography. Plasma levels of h-ANP and BNP were measured on the day of echocardiography. Results: In the group with both higher level of h-ANP and BNP, the DWS was significantly lower than the other 3 groups. This group showed significantly higher values in the ratio of trans-mitral early to late diastolic flow velocity, the ratio of pulmonary venous diastolic to systolic ratio, the septal E/e’, and GLS compared with the other 3 groups. Conclusions: Plasma h-ANP levels in combination with BNP levels provide useful information about cardiac function in patients with AL.