Role of N-terminal pro-B-type natriuretic peptide and troponin T in predicting right ventricular recovery in myocardial infarction

Mustafa Umut Somuncu; Fatih Pasa Tatar; Belma Kalayci; Ahmet Avci; Naile Eris Gudul; Nail Guven Serbest; Ali Riza Demir; Murat Can

doi:10.1515/hmbci-2021-0014

Article

Role of N-terminal pro-B-type natriuretic peptide and troponin T in predicting right ventricular recovery in myocardial infarction

Mustafa Umut Somuncu , Fatih Pasa Tatar , Belma Kalayci , Ahmet Avci , Naile Eris Gudul , Nail Guven Serbest , Ali Riza Demir and Murat Can

Published/Copyright: November 18, 2021

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From the journal Hormone Molecular Biology and Clinical Investigation Volume 43 Issue 1

Abstract

Objectives

The determinants of right ventricular (RV) recovery after successful revascularization in ST-elevation myocardial infarction (STEMI) patients are not clear. Besides, the relationship between Troponin T (TnT), N-terminal pro-B-type natriuretic peptide (NT-proBNP) and improvement in RV function is also unknown. This study hypothesizes that a lower TnT and NT-proBNP level would be associated with RV recovery.

Methods

One hundred forty-eight STEMI patients were included in our study. Echocardiography were performed before and 12–18 weeks after discharge. Patients were divided into three groups according to the changes in tricuspid annular plane systolic excursion (TAPSE) as 53 patients with ≥10% change, 41 patients with 1–9% change, and 54 patients ≤0% change. RV recovery was accepted as ≥10% TAPSE improvement and the predictors of RV recovery were investigated.

Results

RV recovery was detected in 35.8% of the patients. Low baseline left ventricular ejection fraction (OR: 0.91 [0.84–0.98], p=0.023), NT-proBNP (OR: 0.93 [0.89–0.98], p=0.014), TnT (OR: 0.84 [0.68–0.93], p=0.038), inferior myocardial infarction (OR: 2.66 [1.10–6.40], p=0.028), wall motion score index ratio (OR: 0.93 [0.88–0.97], p=0.002) and post-percutaneous coronary intervention TIMI flow 3 (OR: 5.84 [1.41–24.22], p=0.015) were determined as independent predictors of RV recovery. Being in the high TnT group 4.2 times, and being in the high NT-proBNP group 5.3 times could predict the failure to achieve RV recovery. Furthermore, when high TnT level was combined with high NT-proBNP level, the odds ratio of failure to achieve RV recovery was the highest (OR: 8.03 [2.59–24.89], p<0.001).

Conclusions

Lower TnT and lower NT-proBNP level was associated with better improvement in RV function in STEMI patients.

Keywords: cardiac remodeling; myocardial infarction; percutaneous coronary revascularization; right ventricular function

Corresponding author: Mustafa Umut Somuncu, MD, Zonguldak Bülent Ecevit Universitesi Tıp Fakultesi Dekanlıgı, Ibn-i Sina Kampusu, 67600 Esenköy/Kozlu, Zonguldak, Turkey, Phone: +90 532 340 1525, Fax: +90 372 261 02 64, E-mail: usomuncu@gmail.com

Research funding: None declared.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: The local Institutional Review Board deemed the study exempt from review.

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Received: 2021-02-23

Accepted: 2021-11-02

Published Online: 2021-11-18

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Articles in the same Issue

https://doi.org/10.1515/hmbci-2021-0014

Keywords for this article

cardiac remodeling; myocardial infarction; percutaneous coronary revascularization; right ventricular function