Midregional pro-atrial natriuretic peptide is a superior biomarker to N-terminal pro-B-type natriuretic peptide in the diagnosis of heart failure patients with preserved ejection fraction

Objectives: To explore that if mid-regional sequence of pro-A-type natriuretic peptide (MR-proANP) may have a good value of diagnosis in heart failure with preserved ejection fraction (HFpEF) compared with N-terminal pro-B-type natriuretic peptide (NT-proBNP). Methods: Participants with cardiovascular disease who were enrolled in this study were divided into the nonheart failure (non-HF) group (n=75), HFpEF group (n=65), and HF with reduced ejection fraction (HFrEF) group (n=50). The MR-proANP and NT-proBNP levels in plasma from all patients were measured by enzyme-linked immunosorbent assay. Results: The plasma levels of MR-proANP and NT-proBNP in HFpEF and HFrEF groups were higher than those in non-HF group (P<.05). MR-proANP levels were significantly different (P<.05) in different New York Heart Association class patients with HFpEF. In the diagnostic analysis area under the curve of MR-proANP (0.844) was higher than that of NT-proBNP (0.518, P<.001). The left atrial volume index in the HFrEF group was higher than HFpEF group (P<.05); however, both of these groups had a higher index than non-HF group (P<.05). Conclusion: Results indicated that MR-proANP may be more sensitive and specific than NT-proBNP in diagnosing HFpEF. It may be used as a potential diagnostic biomarker in patients with HFpEF.