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N-terminal pro B type natriuretic peptide, but not the new putative cardiac hormone relaxin, predicts prognosis in patients with chronic heart failure
  1. C Fisher1,
  2. C Berry1,
  3. L Blue1,
  4. J J Morton2,
  5. J McMurray1
  1. 1Department of Cardiology, Western Infirmary, Glasgow, UK
  2. 2Department of Biochemistry, Western Infirmary
  1. Correspondence to:
    Professor J J V McMurray, Department of Cardiology, Western Infirmary, Glasgow G12 8QQ, UK;
    j.mcmurray{at}bio.gla.ac.uk

Abstract

Objective: To determine whether the plasma concentration of the putative new cardiac hormone relaxin is predictive of clinical outcome in patients with chronic heart failure (CHF).

Design: Plasma relaxin and N-terminal pro B type natriuretic peptide (NT pro BNP) concentrations were measured in 87 patients admitted in an emergency with CHF caused by left ventricular systolic dysfunction. These were related to death and death or readmission with CHF over the following year.

Setting: Western Infirmary, Glasgow, UK.

Main outcome measures: Plasma concentrations of relaxin and NT pro BNP; time to death or hospitalisation caused by heart failure.

Results: Plasma concentrations of both relaxin and NT pro BNP were greatly increased. Of the 43 patients with NT pro BNP above the group median concentration, 23 (53%) died and 30 (70%) died or were hospitalised with CHF. Among the 44 with concentrations below the median, these numbers were 5 (11%) and 12 (27%), respectively (p < 0.0001 and p < 0.0001, respectively). Plasma NT pro BNP concentration remained an independent predictor of an adverse clinical outcome in a multivariate analysis. Of the 42 patients with a relaxin concentration above the median, 13 (31%) died and 20 (48%) died or were hospitalised. Below the median, these numbers were 15 of 45 (33%) and 22 of 45 (49%) (p = 0.76 and p = 0.84, respectively).

Conclusions: NT pro BNP is a powerful and independent predictor of outcome in CHF, whereas relaxin, also secreted by the heart in increased amounts in CHF, is not.

  • natriuretic peptides
  • relaxin
  • heart failure
  • prognosis
  • survival
  • hospital admission
  • CHF, chronic heart failure
  • ELISA, enzyme linked immunosorbent assay
  • NT pro BNP, N-terminal pro B type natriuretic peptide
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