Recommended Citation
Runnoe H, Bonaguro A, Turbay Caballero V, Ndiaye C, Dela Cruz M. Baseline NTproBNP as a Predictor of 1-Year Heart Failure Hospitalizations in Cardiac Amyloidosis. Presented at Scientific Day; May 20, 2026; Milwaukee, WI.
Abstract
Background/Significance:
Patients with cardiac amyloidosis (CA) are at high risk for morbidity. It remains unclear which biomarkers or echocardiographic parameters can help identify CA patients at the highest risk of short-term hospitalization.
Purpose:
We investigated whether biomarkers or echocardiographic parameters could help identify CA patients at the highest risk of hospitalization within one year.
Methods:
We performed a single-center cohort study of all CA patients from 2019 to 2025 who had a left ventricular ejection fraction (LVEF) and right ventricular- pulmonary arterial pressure coupling (RV-PA coupling ratio) reported at baseline. Patients were divided into groups based on number of heart failure hospitalizations at 1 year: 0 vs 1-2 vs ≥ 2 hospitalizations. The cardiac biomarker N-Terminal pro B-type natriuretic peptide (NTproBNP) and echo-based parameters e.g. LVEF, tricuspid annular plane systolic excursion (TAPSE), and RV-PA coupling ratio as defined by TAPSE/pulmonary artery systolic pressure were compared across groups.
Results:
65 patients were included for analysis (mean age = 78 years, 80% female). 25 patients had Hereditary Transthyretin (TTR) CA, 20 were Wild Type TTR CA, 2 patients AL CA, and 18 had unknown subtypes. Median NTproBNP levels were significantly higher among patients with increasing number of hospitalizations within one year (0 vs 1-2 vs ≥ 2, 1618 pg/mL vs 3036 pg/mL vs 8006 pg/mL, p<0.0001). Other echocardiographic markers such as baseline LVEF (50% vs 46% vs 45%, p=0.368), baseline TAPSE (15.5mm vs 14mm vs 16.5mm, p=0.185), and baseline RV-PA coupling (0.38 vs 0.32 vs 0.4, p=0.06) did not differ between groups.
Conclusion:
Amongst CA patients, increasing NTproBNP levels were associated with an increasing number of heart failure hospitalizations within one year of CA diagnosis. Echocardiographic parameters did not appear to identify patients at a higher risk of short-term hospitalization in our population. Further research is needed to understand which CA subgroups are at the highest risk of short-term morbidity and thus might benefit from early intervention.
Presentation Notes
Presented at Scientific Day; May 20, 2026; Milwaukee, WI.
Full Text of Presentation
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Document Type
Oral/Podium Presentation
Baseline NTproBNP as a Predictor of 1-Year Heart Failure Hospitalizations in Cardiac Amyloidosis
Background/Significance:
Patients with cardiac amyloidosis (CA) are at high risk for morbidity. It remains unclear which biomarkers or echocardiographic parameters can help identify CA patients at the highest risk of short-term hospitalization.
Purpose:
We investigated whether biomarkers or echocardiographic parameters could help identify CA patients at the highest risk of hospitalization within one year.
Methods:
We performed a single-center cohort study of all CA patients from 2019 to 2025 who had a left ventricular ejection fraction (LVEF) and right ventricular- pulmonary arterial pressure coupling (RV-PA coupling ratio) reported at baseline. Patients were divided into groups based on number of heart failure hospitalizations at 1 year: 0 vs 1-2 vs ≥ 2 hospitalizations. The cardiac biomarker N-Terminal pro B-type natriuretic peptide (NTproBNP) and echo-based parameters e.g. LVEF, tricuspid annular plane systolic excursion (TAPSE), and RV-PA coupling ratio as defined by TAPSE/pulmonary artery systolic pressure were compared across groups.
Results:
65 patients were included for analysis (mean age = 78 years, 80% female). 25 patients had Hereditary Transthyretin (TTR) CA, 20 were Wild Type TTR CA, 2 patients AL CA, and 18 had unknown subtypes. Median NTproBNP levels were significantly higher among patients with increasing number of hospitalizations within one year (0 vs 1-2 vs ≥ 2, 1618 pg/mL vs 3036 pg/mL vs 8006 pg/mL, p<0.0001). Other echocardiographic markers such as baseline LVEF (50% vs 46% vs 45%, p=0.368), baseline TAPSE (15.5mm vs 14mm vs 16.5mm, p=0.185), and baseline RV-PA coupling (0.38 vs 0.32 vs 0.4, p=0.06) did not differ between groups.
Conclusion:
Amongst CA patients, increasing NTproBNP levels were associated with an increasing number of heart failure hospitalizations within one year of CA diagnosis. Echocardiographic parameters did not appear to identify patients at a higher risk of short-term hospitalization in our population. Further research is needed to understand which CA subgroups are at the highest risk of short-term morbidity and thus might benefit from early intervention.
Affiliations
Advocate Christ Medical Center