Prognostic value of plasma big endothelin-1 in left ventricular non-compaction cardiomyopathy

Heart. 2021 May;107(10):836-841. doi: 10.1136/heartjnl-2020-317059. Epub 2020 Oct 14.

Abstract

Objective: To determine the prognostic role of big endothelin-1 (ET-1) in left ventricular non-compaction cardiomyopathy (LVNC).

Methods: We prospectively enrolled patients whose LVNC was diagnosed by cardiac MRI and who had big ET-1 data available. Primary end point was a composite of all-cause mortality, heart transplantation, sustained ventricular tachycardia/fibrillation and implanted cardioverter defibrillator discharge. Secondary end point was cardiac death or heart transplantation.

Results: Altogether, 203 patients (median age 44 years; 70.9% male) were divided into high-level (≥0.42 pmol/L) and low-level (<0.42 pmol/L) big ET-1 groups according to the median value of plasma big ET-1 levels. Ln big ET-1 was positively associated with Ln N-terminal pro-brain natriuretic peptide, left ventricular diameter, but negatively related to age and Ln left ventricular ejection fraction. Median follow-up was 1.9 years (IQR 0.9-3.1 years). Kaplan-Meier analysis showed that, compared with patients with low levels of big ET-1, those with high levels were at greater risk for meeting both primary (p<0.001) and secondary (p<0.001) end points. The C-statistic estimation of Ln big ET-1 for predicting the primary outcome was 0.755 (95% CI 0.685 to 0.824, p<0.001). After adjusting for confounding factors, Ln big ET-1 was identified as an independent predictor of the composite primary outcome (HR 1.83, 95% CI 1.27 to 2.62, p=0.001) and secondary outcome (HR 1.93, 95% CI 1.32 to 2.83, p=0.001).

Conclusions: Plasma big ET-1 may be a valuable index to predict the clinical adverse outcomes in patients with LVNC.

Keywords: myocardial disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers / blood
  • Death, Sudden, Cardiac / epidemiology
  • Defibrillators, Implantable / statistics & numerical data
  • Endothelin-1 / blood*
  • Female
  • Heart Transplantation / statistics & numerical data
  • Heart Ventricles / diagnostic imaging
  • Humans
  • Isolated Noncompaction of the Ventricular Myocardium / complications*
  • Isolated Noncompaction of the Ventricular Myocardium / mortality*
  • Isolated Noncompaction of the Ventricular Myocardium / therapy
  • Magnetic Resonance Imaging, Cine
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood
  • Peptide Fragments / blood
  • Prognosis
  • Prospective Studies
  • Stroke Volume
  • Tachycardia, Ventricular / epidemiology
  • Ventricular Fibrillation / epidemiology

Substances

  • Biomarkers
  • Endothelin-1
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain