B-type natriuretic peptide changes and left ventricular remodeling dynamics in heart failure with reduced ejection fraction
Year: 2026
Type: article
Study design: Observational Study
Abstract: ABSTRACT Background B-type natriuretic peptide (BNP) is an important biomarker in heart failure with reduced ejection fraction (HFrEF). We aimed to explore changes in BNP and their relationship with long-term dynamics of left ventricular (LV) geometry. Methods This was a single-center retrospective cohort. Inclusion criteria included LV ejection fraction (LVEF) <40% measured by echocardiography, BNP ≥100 pg/mL at baseline, and a subsequent BNP measure within a year. Percent BNP change from baseline was computed and divided into tertiles. Tertiles represented decreasing, minimal changes, and rising BNP levels. The study endpoint included LV internal dimension at end-systole (LVIDs), LV internal dimension at end-diastole (LVIDd), and LVEF. The secondary endpoint consisted of all-cause mortality. Results A total of 887 patients were included. Baseline characteristics, including age, sex, blood pressure, atrial fibrillation, baseline BNP, and LVEF, varied among tertiles (p<0.05). When comparing to the rising BNP tertile, the decreasing BNP tertile showed decreased trends of LVIDs (p=0.001), LVIDd (p=0.006); and increased trends of LVEF (p=0.008). All-cause mortality was higher in the rising BNP tertile (p<0.05) compared to the decreasing tertile. Conclusion In a real-world routine HFrEF cohort, this study demonstrates the time-dependent relationship between BNP changes, LV remodeling dynamics, and survival outcomes. Findings contribute to the literature supporting BNP as a dynamic marker for LV remodeling. Clinical Perspective What is new? In a real-world HFrEF cohort, this study demonstrates the time-dependent relationship between BNP changes, LV remodeling dynamics, and survival outcomes. What are the clinical implications? Results contribute to the literature supporting early BNP changes as a potential surrogate marker for adverse LV remodeling in a time-dependent fashion.
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
Awards: Psychosocial stRessors and Exposomics on CV health In underServed multiEthnic populations in Northern CA (PRECISE), Psychosocial stressors and exposomics on CV health in underserved multiethnic populations in Northern California, Mechanistic links between inflammatory cascades and psychosocial stressors in CVD, G9000084546, G9000134830, G954386746
OpenAlex ID: W7119153530