Home Mid-regional pro-adrenomedullin (MR-proADM) and mid-regional pro-atrial natriuretic peptide (MR-proANP) in severe aortic valve stenosis: association with outcome after transcatheter aortic valve implantation (TAVI)
Article
Licensed
Unlicensed Requires Authentication

Mid-regional pro-adrenomedullin (MR-proADM) and mid-regional pro-atrial natriuretic peptide (MR-proANP) in severe aortic valve stenosis: association with outcome after transcatheter aortic valve implantation (TAVI)

  • Gerd Baldenhofer , Michael Laule , Martin Mockel , Wasiem Sanad , Fabian Knebel , Henryk Dreger , Franziska Leonhardt , Michael Sander , Herko Grubitzsch , Gert Baumann , Karl Stangl EMAIL logo and Verena Stangl
Published/Copyright: August 15, 2016
Become an author with De Gruyter Brill
Submit Manuscript Author Information
Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 55 Issue 2

Abstract

Background:

This study aimed to assess the association of mid-regional (MR) pro-adrenomedullin (MR-proADM) and MR-pro-A-type natriuretic peptide (MR-proANP) in comparison to N-terminal pro-natriuretic peptide (NT-proBNP) with outcome in patients with aortic stenosis (AS) treated with transcatheter aortic valve implantation (TAVI).

Methods:

One hundred consecutive TAVI patients were included in this prospective study. Association of preinterventional levels of MR-proADM, MR-proANP, NT-proBNP, C-reactive protein (CrP), and high-sensitive cardiac Troponin T (hsTN) with 30-day and 1-year outcome was analyzed.

Results:

There was no association with 30-day outcome, but all markers were associated with 1-year cardiovascular events and all-cause mortality. The combined biomarker analysis further improved risk prediction.

Conclusions:

In TAVI patients MR-proADM, MR-proANP, and NT-proBNP are promising predictors of adverse events within 1 year. Integration of these biomarkers into decision pathways may help to identify patients at higher risk.

Keywords: aortic valve stenosis; MR-proADM; MR-proANP; NT-proBNP; transcatheter aortic valve implantation
Corresponding author: Karl Stangl, MD, Medizinische Klinik für Kardiologie und Angiologie, Charite Campus Mitte – Universitätsmedizin Berlin, Schumannstr. 20-21, 10117 Berlin, Germany, Phone: (+49 30) 450 513 075, Fax: (+49 30) 450 513 932
aGerd Baldenhofer and Michael Laule contributed equally to this work.

Acknowledgments

The authors thank Mrs. Urte Lemma and Mrs. Ulrike Günther for help in organization and realization of the study.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: Michael Laule and Karl Stangl receive TAVI proctoring and consultancy fees from Edwards Lifesciences and Medtronic.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

References

1. Vahanian A, Alfieri O, Andreotti F, Antunes MJ, Baron-Esquivias G, Baumgartner H, et al. Guidelines on the management of valvular heart disease (version 2012): the Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur J Cardiothorac Surg 2012;42:S1–44.10.1093/ejcts/ezs455Search in Google Scholar PubMed

2. Ben-Dor I, Gaglia MA, Jr., Barbash IM, Maluenda G, Hauville C, Gonzalez MA, et al. Comparison between Society of Thoracic Surgeons score and logistic EuroSCORE for predicting mortality in patients referred for transcatheter aortic valve implantation. Cardiovasc Revasc Med 2011;12:345–9.10.1016/j.carrev.2011.04.005Search in Google Scholar PubMed

3. Webb J, Rodes-Cabau J, Fremes S, Pibarot P, Ruel M, Ibrahim R, et al. Transcatheter aortic valve implantation: a Canadian Cardiovascular Society position statement. Can J Cardiol 2012;28:520–8.10.1016/j.cjca.2012.04.015Search in Google Scholar PubMed

4. Wenaweser P, Stortecky S, Schwander S, Heg D, Huber C, Pilgrim T, et al. Clinical outcomes of patients with estimated low or intermediate surgical risk undergoing transcatheter aortic valve implantation. Eur Heart J 2013;34:1894–905.10.1093/eurheartj/eht086Search in Google Scholar PubMed

5. Sinning JM, Ghanem A, Steinhauser H, Adenauer V, Hammerstingl C, Nickenig G, et al. Renal function as predictor of mortality in patients after percutaneous transcatheter aortic valve implantation. JACC Cardiovasc Interv 2010;3:1141–9.10.1016/j.jcin.2010.09.009Search in Google Scholar PubMed

6. Thomas M, Schymik G, Walther T, Himbert D, Lefevre T, Treede H, et al. One-year outcomes of cohort 1 in the Edwards SAPIEN Aortic Bioprosthesis European Outcome (SOURCE) registry: the European registry of transcatheter aortic valve implantation using the Edwards SAPIEN valve. Circulation 2011;124:425–33.10.1161/CIRCULATIONAHA.110.001545Search in Google Scholar PubMed

7. Rodes-Cabau J, Webb JG, Cheung A, Ye J, Dumont E, Osten M, et al. Long-term outcomes after transcatheter aortic valve implantation: insights on prognostic factors and valve durability from the Canadian multicenter experience. J Am Coll Cardiol 2012;60:1864–75.10.1016/j.jacc.2012.08.960Search in Google Scholar PubMed

8. Schoenenberger AW, Stortecky S, Neumann S, Moser A, Juni P, Carrel T, et al. Predictors of functional decline in elderly patients undergoing transcatheter aortic valve implantation (TAVI). Eur Heart J 2013;34:684–92.10.1093/eurheartj/ehs304Search in Google Scholar PubMed

9. Kefer J, Beauloye C, Astarci P, Renkin J, Glineur D, Dekleermaeker A, et al. Usefulness of B-type natriuretic peptide to predict outcome of patients treated by transcatheter aortic valve implantation. Am J Cardiol 2010;106:1782–6.10.1016/j.amjcard.2010.07.051Search in Google Scholar PubMed

10. Parenica J, Nemec P, Tomandl J, Ondrasek J, Pavkova-Goldbergova M, Tretina M, et al. Prognostic utility of biomarkers in predicting of one-year outcomes in patients with aortic stenosis treated with transcatheter or surgical aortic valve implantation. PLoS One 2012;7:e48851.10.1371/journal.pone.0048851Search in Google Scholar PubMed PubMed Central

11. Lopez-Otero D, Trillo-Nouche R, Gude F, Cid-Alvarez B, Ocaranza-Sanchez R, Alvarez MS, et al. Pro B-type natriuretic peptide plasma value: a new criterion for the prediction of short- and long-term outcomes after transcatheter aortic valve implantation. Int J Cardiol 2013;168:1264–8.10.1016/j.ijcard.2012.11.116Search in Google Scholar PubMed

12. Baldenhofer G, Zhang K, Spethmann S, Laule M, Eilers B, Leonhardt F, et al. Galectin-3 predicts short- and long-term outcome in patients undergoing transcatheter aortic valve implantation (TAVI). Int J Cardiol 2014;177:912–7.10.1016/j.ijcard.2014.10.010Search in Google Scholar PubMed

13. Maisel A, Mueller C, Nowak R, Peacock WF, Landsberg JW, Ponikowski P, et al. Mid-region pro-hormone markers for diagnosis and prognosis in acute dyspnea: results from the BACH (Biomarkers in Acute Heart Failure) trial. J Am Coll Cardiol 2010;55:2062–76.10.1016/j.jacc.2010.02.025Search in Google Scholar PubMed

14. Shah RV, Truong QA, Gaggin HK, Pfannkuche J, Hartmann O, Januzzi JL, Jr. Mid-regional pro-atrial natriuretic peptide and pro-adrenomedullin testing for the diagnostic and prognostic evaluation of patients with acute dyspnoea. Eur Heart J 2012;33:2197–205.10.1093/eurheartj/ehs136Search in Google Scholar PubMed PubMed Central

15. Gegenhuber A, Struck J, Poelz W, Pacher R, Morgenthaler NG, Bergmann A, et al. Midregional pro-A-type natriuretic peptide measurements for diagnosis of acute destabilized heart failure in short-of-breath patients: comparison with B-type natriuretic peptide (BNP) and amino-terminal proBNP. Clin Chem 2006;52:827–31.10.1373/clinchem.2005.065441Search in Google Scholar PubMed

16. Eckstein J, Potocki M, Murray K, Breidthardt T, Ziller R, Mosimann T, et al. Direct comparison of mid-regional pro-atrial natriuretic peptide with N-terminal pro B-type natriuretic peptide in the diagnosis of patients with atrial fibrillation and dyspnoea. Heart 2012;98:1518–22.10.1136/heartjnl-2012-302260Search in Google Scholar PubMed

17. Klip IT, Voors AA, Anker SD, Hillege HL, Struck J, Squire I, et al. Prognostic value of mid-regional pro-adrenomedullin in patients with heart failure after an acute myocardial infarction. Heart 2011;97:892–8.10.1136/hrt.2010.210948Search in Google Scholar PubMed

18. von Haehling S, Jankowska EA, Morgenthaler NG, Vassanelli C, Zanolla L, Rozentryt P, et al. Comparison of midregional pro-atrial natriuretic peptide with N-terminal pro-B-type natriuretic peptide in predicting survival in patients with chronic heart failure. J Am Coll Cardiol 2007;50:1973–80.10.1016/j.jacc.2007.08.012Search in Google Scholar PubMed

19. Potocki M, Ziller R, Mueller C. Mid-regional pro-adrenomedullin in acute heart failure: a better biomarker or just another biomarker? Curr Heart Fail Rep 2012;9:244–51.10.1007/s11897-012-0096-6Search in Google Scholar PubMed

20. Hu Z, Han Z, Huang Y, Sun Y, Li B, Deng A. Diagnostic power of the mid-regional pro-atrial natriuretic peptide for heart failure patients with dyspnea: a meta-analysis. Clin Biochem 2012;45:1634–9.10.1016/j.clinbiochem.2012.08.028Search in Google Scholar PubMed

21. Cinar O, Cevik E, Acar A, Kaya C, Ardic S, Comert B, et al. Evaluation of mid-regional pro-atrial natriuretic peptide, procalcitonin, and mid-regional pro-adrenomedullin for the diagnosis and risk stratification of dyspneic ED patients. Am J Emerg Med 2012;30:1915–20.10.1016/j.ajem.2012.04.009Search in Google Scholar PubMed

22. Jougasaki M, Wei CM, McKinley LJ, Burnett JC, Jr. Elevation of circulating and ventricular adrenomedullin in human congestive heart failure. Circulation 1995;92:286–9.10.1161/01.CIR.92.3.286Search in Google Scholar

23. Nagaya N, Satoh T, Nishikimi T, Uematsu M, Furuichi S, Sakamaki F, et al. Hemodynamic, renal, and hormonal effects of adrenomedullin infusion in patients with congestive heart failure. Circulation 2000;101:498–503.10.1161/01.CIR.101.5.498Search in Google Scholar PubMed

24. Stangl V, Baldenhofer G, Knebel F, Zhang K, Sanad W, Spethmann S, et al. Impact of gender on three-month outcome and left ventricular remodeling after transfemoral transcatheter aortic valve implantation. Am J Cardiol 2012;110:884–90.10.1016/j.amjcard.2012.04.063Search in Google Scholar PubMed

25. Kappetein AP, Head SJ, Genereux P, Piazza N, van Mieghem NM, Blackstone EH, et al. Updated standardized endpoint definitions for transcatheter aortic valve implantation: the Valve Academic Research Consortium-2 consensus document. Eur Heart J 2012;33:2403–18.10.1093/eurheartj/ehs255Search in Google Scholar PubMed

26. Leon MB, Smith CR, Mack M, Miller DC, Moses JW, Svensson LG, et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med 2010;363:1597–607.10.1056/NEJMoa1008232Search in Google Scholar PubMed

27. Tamburino C, Capodanno D, Ramondo A, Petronio AS, Ettori F, Santoro G, et al. Incidence and predictors of early and late mortality after transcatheter aortic valve implantation in 663 patients with severe aortic stenosis. Circulation 2011;123: 299–308.10.1161/CIRCULATIONAHA.110.946533Search in Google Scholar PubMed

28. Smith CR, Leon MB, Mack MJ, Miller DC, Moses JW, Svensson LG, et al. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med 2011;364:2187–98.10.1056/NEJMoa1103510Search in Google Scholar PubMed

29. Pedrazzini GB, Masson S, Latini R, Klersy C, Rossi MG, Pasotti E, et al. Comparison of brain natriuretic peptide plasma levels versus logistic EuroSCORE in predicting in-hospital and late postoperative mortality in patients undergoing aortic valve replacement for symptomatic aortic stenosis. Am J Cardiol 2008;102:749–54.10.1016/j.amjcard.2008.04.055Search in Google Scholar PubMed

30. Daniels LB, Clopton P, Potocki M, Mueller C, McCord J, Richards M, et al. Influence of age, race, sex, and body mass index on interpretation of midregional pro atrial natriuretic peptide for the diagnosis of acute heart failure: results from the BACH multinational study. Eur J Heart Fail 2012;14:22–31.10.1093/eurjhf/hfr157Search in Google Scholar PubMed

31. Mason JM, Hancock HC, Close H, Murphy JJ, Fuat A, de Belder M, et al. Utility of biomarkers in the differential diagnosis of heart failure in older people: findings from the heart failure in care homes (HFinCH) diagnostic accuracy study. PLoS One 2013;8:e53560.10.1371/journal.pone.0053560Search in Google Scholar

32. Nagaya N, Nishikimi T, Uematsu M, Satoh T, Kyotani S, Sakamaki F, et al. Plasma brain natriuretic peptide as a prognostic indicator in patients with primary pulmonary hypertension. Circulation 2000;102:865–70.10.1161/01.CIR.102.8.865Search in Google Scholar

33. Stangl K, Dschietzig T, Richter C, Stangl V, Bartsch C, Zurbrugg HR, et al. Cessation of pulmonary and coronary secretion of adrenomedullin peptides in the progression of human heart failure. Horm Metab Res 2002;34:81–6.10.1055/s-2002-20520Search in Google Scholar

34. Potocki M, Breidthardt T, Reichlin T, Morgenthaler NG, Bergmann A, Noveanu M, et al. Midregional pro-adrenomedullin in addition to b-type natriuretic peptides in the risk stratification of patients with acute dyspnea: an observational study. Crit Care 2009;13:R122.10.1186/cc7975Search in Google Scholar

35. Adlbrecht C, Hulsmann M, Strunk G, Berger R, Mortl D, Struck J, et al. Prognostic value of plasma midregional pro-adrenomedullin and C-terminal-pro-endothelin-1 in chronic heart failure outpatients. Eur J Heart Fail 2009;11:361–6.10.1093/eurjhf/hfp004Search in Google Scholar

36. Potocki M, Breidthardt T, Reichlin T, Hartwiger S, Morgenthaler NG, Bergmann A, et al. Comparison of midregional pro-atrial natriuretic peptide with N-terminal pro-B-type natriuretic peptide in the diagnosis of heart failure. J Intern Med 2010;267:119–29.10.1111/j.1365-2796.2009.02135.xSearch in Google Scholar

37. Gerber IL, Stewart RA, Legget ME, West TM, French RL, Sutton TM, et al. Increased plasma natriuretic peptide levels reflect symptom onset in aortic stenosis. Circulation 2003;107:1884–90.10.1161/01.CIR.0000060533.79248.0CSearch in Google Scholar

38. Talwar S, Downie PF, Squire IB, Davies JE, Barnett DB, Ng LL. Plasma N-terminal pro BNP and cardiotrophin-1 are elevated in aortic stenosis. Eur J Heart Fail 2001;3:15–9.10.1016/S1388-9842(00)00074-XSearch in Google Scholar

39. Bergler-Klein J, Klaar U, Heger M, Rosenhek R, Mundigler G, Gabriel H, et al. Natriuretic peptides predict symptom-free survival and postoperative outcome in severe aortic stenosis. Circulation 2004;109:2302–8.10.1161/01.CIR.0000126825.50903.18Search in Google Scholar PubMed

40. Moertl D, Berger R, Struck J, Gleiss A, Hammer A, Morgenthaler NG, et al. Comparison of midregional pro-atrial and B-type natriuretic peptides in chronic heart failure: influencing factors, detection of left ventricular systolic dysfunction, and prediction of death. J Am Coll Cardiol 2009;53:1783–90.10.1016/j.jacc.2009.01.057Search in Google Scholar PubMed

41. Masson S, Latini R, Carbonieri E, Moretti L, Rossi MG, Ciricugno S, et al. The predictive value of stable precursor fragments of vasoactive peptides in patients with chronic heart failure: data from the GISSI-heart failure (GISSI-HF) trial. Eur J Heart Fail 2010;12:338–47.10.1093/eurjhf/hfp206Search in Google Scholar

42. Genereux P, Head SJ, Van Mieghem NM, Kodali S, Kirtane AJ, Xu K, et al. Clinical outcomes after transcatheter aortic valve replacement using valve academic research consortium definitions: a weighted meta-analysis of 3,519 patients from 16 studies. J Am Coll Cardiol 2012;59:2317–26.10.1016/S0735-1097(12)60229-0Search in Google Scholar

Supplemental Material:

The online version of this article (DOI: 10.1515/cclm-2015-0419) offers supplementary material, available to authorized users.

Received: 2016-5-4
Accepted: 2016-6-27
Published Online: 2016-8-15
Published in Print: 2017-2-1

©2017 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Commutable samples with assigned target concentrations may help us harmonise general chemistry results
  4. Reviews
  5. Performance of point-of-care HbA1c test devices: implications for use in clinical practice – a systematic review and meta-analysis
  6. Cardiac troponins and mortality in type 1 and 2 myocardial infarction
  7. Opinion Paper
  8. Criteria for assigning laboratory measurands to models for analytical performance specifications defined in the 1st EFLM Strategic Conference
  9. Genetics and Molecular Diagnostics
  10. External quality assessment for human papillomavirus 16/18 DNA detection and genotyping in Shanghai, China
  11. General Clinical Chemistry and Laboratory Medicine
  12. Analytical performance of 17 general chemistry analytes across countries and across manufacturers in the INPUtS project of EQA organizers in Italy, the Netherlands, Portugal, United Kingdom and Spain
  13. Commutability of proficiency testing material containing tobramycin: a study within the framework of the Dutch Calibration 2.000 project
  14. Optimization and validation of moving average quality control procedures using bias detection curves and moving average validation charts
  15. Extending laboratory automation to the wards: effect of an innovative pneumatic tube system on diagnostic samples and transport time
  16. Smart management of sample dilution using an artificial neural network to achieve streamlined processes and saving resources: the automated nephelometric testing of serum free light chain as case study
  17. An integrated proteomic and peptidomic assessment of the normal human urinome
  18. An alternative inhibition method for determining cross-reactive allergens
  19. Validation of a new assay for α-synuclein detection in cerebrospinal fluid
  20. Reference Values and Biological Variations
  21. Intra-individual variation of plasma trimethylamine-N-oxide (TMAO), betaine and choline over 1 year
  22. Cancer Diagnostics
  23. Predictive performance of TPA testing for recurrent disease during follow-up after curative intent surgery for colorectal carcinoma
  24. Cardiovascular Diseases
  25. Mid-regional pro-adrenomedullin (MR-proADM) and mid-regional pro-atrial natriuretic peptide (MR-proANP) in severe aortic valve stenosis: association with outcome after transcatheter aortic valve implantation (TAVI)
  26. Association between apolipoprotein E polymorphisms and premature coronary artery disease: a meta-analysis
  27. Urinary orosomucoid: a novel, early biomarker of sepsis with promising diagnostic performance
  28. Letters to the Editor
  29. CT or MRI
  30. Reply to: CT or MRI in the diagnosis of right lower quadrant abdominal pain?
  31. Quantification of daratumumab in the serum protein electrophoresis
  32. Response to: Interference of daratumumab on the serum protein electrophoresis
  33. Glycated albumin: correlation to HbA1c and preliminary reference interval evaluation
  34. Using “big data” to describe the effect of seasonal variation in thyroid-stimulating hormone
  35. IgE multiple myeloma: a new case report
  36. Therapeutic decision-making process in the intensive care unit: role of biological point-of-care testing
  37. How can we evaluate differences between serial measurements on the same sample? A new approach based on within-subject biological variation
https://doi.org/10.1515/cclm-2015-0419
Keywords for this article
aortic valve stenosis; MR-proADM; MR-proANP; NT-proBNP; transcatheter aortic valve implantation

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Commutable samples with assigned target concentrations may help us harmonise general chemistry results
  4. Reviews
  5. Performance of point-of-care HbA1c test devices: implications for use in clinical practice – a systematic review and meta-analysis
  6. Cardiac troponins and mortality in type 1 and 2 myocardial infarction
  7. Opinion Paper
  8. Criteria for assigning laboratory measurands to models for analytical performance specifications defined in the 1st EFLM Strategic Conference
  9. Genetics and Molecular Diagnostics
  10. External quality assessment for human papillomavirus 16/18 DNA detection and genotyping in Shanghai, China
  11. General Clinical Chemistry and Laboratory Medicine
  12. Analytical performance of 17 general chemistry analytes across countries and across manufacturers in the INPUtS project of EQA organizers in Italy, the Netherlands, Portugal, United Kingdom and Spain
  13. Commutability of proficiency testing material containing tobramycin: a study within the framework of the Dutch Calibration 2.000 project
  14. Optimization and validation of moving average quality control procedures using bias detection curves and moving average validation charts
  15. Extending laboratory automation to the wards: effect of an innovative pneumatic tube system on diagnostic samples and transport time
  16. Smart management of sample dilution using an artificial neural network to achieve streamlined processes and saving resources: the automated nephelometric testing of serum free light chain as case study
  17. An integrated proteomic and peptidomic assessment of the normal human urinome
  18. An alternative inhibition method for determining cross-reactive allergens
  19. Validation of a new assay for α-synuclein detection in cerebrospinal fluid
  20. Reference Values and Biological Variations
  21. Intra-individual variation of plasma trimethylamine-N-oxide (TMAO), betaine and choline over 1 year
  22. Cancer Diagnostics
  23. Predictive performance of TPA testing for recurrent disease during follow-up after curative intent surgery for colorectal carcinoma
  24. Cardiovascular Diseases
  25. Mid-regional pro-adrenomedullin (MR-proADM) and mid-regional pro-atrial natriuretic peptide (MR-proANP) in severe aortic valve stenosis: association with outcome after transcatheter aortic valve implantation (TAVI)
  26. Association between apolipoprotein E polymorphisms and premature coronary artery disease: a meta-analysis
  27. Urinary orosomucoid: a novel, early biomarker of sepsis with promising diagnostic performance
  28. Letters to the Editor
  29. CT or MRI
  30. Reply to: CT or MRI in the diagnosis of right lower quadrant abdominal pain?
  31. Quantification of daratumumab in the serum protein electrophoresis
  32. Response to: Interference of daratumumab on the serum protein electrophoresis
  33. Glycated albumin: correlation to HbA1c and preliminary reference interval evaluation
  34. Using “big data” to describe the effect of seasonal variation in thyroid-stimulating hormone
  35. IgE multiple myeloma: a new case report
  36. Therapeutic decision-making process in the intensive care unit: role of biological point-of-care testing
  37. How can we evaluate differences between serial measurements on the same sample? A new approach based on within-subject biological variation
Sign up now to receive a 20% welcome discount
Institutional Access
How does access work?
Have an idea on how to improve our website?
Please write us.
© 2025 De Gruyter Brill
Downloaded on 17.9.2025 from https://www.degruyterbrill.com/document/doi/10.1515/cclm-2015-0419/html
Scroll to top button