Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2024 Dec 3;150(23):1847-1857.
doi: 10.1161/CIRCULATIONAHA.124.069735. Epub 2024 Sep 24.

NT-proBNP and Cardiac Troponin I, but Not Cardiac Troponin T, Are Associated With 7-Year Changes in Cardiac Structure and Function in Older Adults: The ARIC Study

Peder L Myhre  1 , Brian Claggett  2 , Christie M Ballantyne  3 , Ron C Hoogeveen  3 , Elizabeth Selvin  4 , Kunihiro Matsushita  4 , Dalane Kitzman  5 , Suma Konety  6 , Thomas Mosley  7 , Amil M Shah  8
Affiliations
Multicenter Study

NT-proBNP and Cardiac Troponin I, but Not Cardiac Troponin T, Are Associated With 7-Year Changes in Cardiac Structure and Function in Older Adults: The ARIC Study

Peder L Myhre et al. Circulation. .

Abstract

Background: Higher circulating concentrations of NT-proBNP (N-terminal pro-B-type natriuretic peptide) and high-sensitivity cardiac troponin T (hs-cTnT) and I (hs-cTnI) are associated with left ventricular remodeling and with incident heart failure. The associations of these cardiac biomarkers with changes in cardiac structure and function over time are uncharacterized.

Methods: Among 2006 participants in the ARIC prospective cohort study (Atherosclerosis Risk in Communities) who were free of overt cardiovascular disease and underwent echocardiography at study visits 5 (2011- 2013) and 7 (2018-2019), we assessed the associations of NT-proBNP, hs-cTnT, and hs-cTnI concentrations at visit 5 with changes in left ventricular structure and function between visits 5 and 7 (≈7-year change) using multivariable linear regression with the biomarkers modeled as restricted cubic splines. Models were adjusted for age, sex, race, body mass index, smoking, diabetes, hypertension, and renal function at visit 5; blood pressure and heart rate at both visits; and the baseline value of the echocardiographic parameter of interest.

Results: Mean±SD age was 74±4 years at visit 5; 61% were women; and 23% were Black adults. Median (25th-75th percentile) concentrations at visit 5 of NT-proBNP, hs-cTnT, and hs-cTnI were 87 ng/L (50-157 ng/L), 9 ng/L (6-12 ng/L), and 2.6 ng/L (1.9-3.9 ng/L). In adjusted models, elevated baseline concentrations of NT-proBNP and hs-cTnI were significantly associated with 7-year decline in left ventricular systolic function (ejection fraction, longitudinal and circumferential strain) and worsening diastolic indices. In contrast, elevated baseline concentrations of hs-cTnT were not significantly associated with 7-year changes in cardiac structure, systolic function, or diastolic function (all P>0.05).

Conclusions: Higher concentrations of NT-proBNP and hs-cTnI, but not hs-cTnT, were associated with greater declines in left ventricular function over ≈7 years in late life independently of traditional cardiovascular risk factors.

Keywords: echocardiography; heart; pro-brain natriuretic peptide; troponin.

PubMed Disclaimer

Conflict of interest statement

Dr Myhre has consulted for Amarin, AmGen, AstraZeneca, Bayer, Boehringer-Ingelheim, Bristol Myers Squibb, Novartis, Novo Nordisk, Pharmacosmos, Roche Diagnostics, Sanofi, Us2.ai, and Vifor. Dr Ballantyne has been a consultant for Abbott Diagnostics and Roche Diagnostics. Dr Shah has received research support from Novartis and consulting fees from Philips Ultrasound and Janssen. The other authors report no conflicts.

Figures

Figure 1.
Figure 1.. NT-proBNP in association to 7-year changes in LV structure and function
Restricted cubic spline models of baseline (visit 5) NTproBNP with 7 changes in LV structure and function from baseline to follow-up (visit 7). Models were adjusted for age, sex, race, and systolic blood pressure and heart rate at baseline and at follow-up, and the following covariates assessed at baseline: body mass index, smoking, diabetes, hypertension, estimated glomerular filtration rate. The best model fit was selected based on the lowest Bayesian information criterion, which was linear for all. The dashed lines represent the 95% confidence intervals, and the bars represent a histogram of the participant distribution.
Figure 2.
Figure 2.. hs-cTnT in association to 7-year changes in LV structure and function
Restricted cubic spline models of baseline (visit 5) hs-cTnT with 7 changes in LV structure and function from baseline to follow-up (visit 7). Models were adjusted for age, sex, race, and systolic blood pressure and heart rate at baseline and at follow-up, and the following covariates assessed at baseline: body mass index, smoking, diabetes, hypertension, estimated glomerular filtration rate. The best model fit was selected based on the lowest Bayesian information criterion, which was linear for all. The dashed lines represent the 95% confidence intervals, and the bars represent a histogram of the participant distribution.
Figure 3.
Figure 3.. hs-cTnI in association to 7-year changes in LV structure and function
Restricted cubic spline models of baseline (visit 5) hs-cTnI with 7 changes in LV structure and function from baseline to follow-up (visit 7). Models were adjusted for age, sex, race, and systolic blood pressure and heart rate at baseline and at follow-up, and the following covariates assessed at baseline: body mass index, smoking, diabetes, hypertension, estimated glomerular filtration rate. The best model fit was selected based on the lowest Bayesian information criterion, which was linear for all, except for MWT, GLS, GCS and TRV max, which was non-linear (3 knots). The dashed lines represent the 95% confidence intervals, and the bars represent a histogram of the participant distribution.
See this image and copyright information in PMC

References

    1. Triposkiadis F, Xanthopoulos A, Butler J. Cardiovascular Aging and Heart Failure: JACC Review Topic of the Week. Journal of the American College of Cardiology. 2019;74:804–813. doi: 10.1016/j.jacc.2019.06.053 - DOI - PubMed
    1. Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145:e895–e1032. doi: doi: 10.1161/CIR.0000000000001063 - DOI - PubMed
    1. Iwanaga Y, Nishi I, Furuichi S, Noguchi T, Sase K, Kihara Y, Goto Y, Nonogi H. B-type natriuretic peptide strongly reflects diastolic wall stress in patients with chronic heart failure: comparison between systolic and diastolic heart failure. J Am Coll Cardiol. 2006;47:742–748. doi: 10.1016/j.jacc.2005.11.030 - DOI - PubMed
    1. Wang TJ, Larson MG, Levy D, Benjamin EJ, Leip EP, Omland T, Wolf PA, Vasan RS. Plasma natriuretic peptide levels and the risk of cardiovascular events and death. N Engl J Med. 2004;350:655–663. doi: 10.1056/NEJMoa031994 - DOI - PubMed
    1. Nambi V, Liu X, Chambless LE, de Lemos JA, Virani SS, Agarwal S, Boerwinkle E, Hoogeveen RC, Aguilar D, Astor BC, et al. Troponin T and N-terminal pro-B-type natriuretic peptide: a biomarker approach to predict heart failure risk--the atherosclerosis risk in communities study. Clin Chem. 2013;59:1802–1810. doi: 10.1373/clinchem.2013.203638 - DOI - PMC - PubMed

Publication types