Association Between Change in Ambulatory Pulmonary Artery Pressures and Natriuretic Peptides in Patients with Heart Failure: Results from the EMBRACE-HF Trial.

BACKGROUND: Remote monitoring of pulmonary artery (PA) pressures and serial NT-proBNP measurements guide heart failure (HF) treatment, but their association has yet to be described.

METHODS: In the Empagliflozin Evaluation by Measuring the Impact on Hemodynamics in Patients with Heart Failure (EMBRACE-HF) trial, patients with HF and a remote PA pressure monitoring device were randomized to empagliflozin versus placebo. PA diastolic pressures (PADP) and NT-proBNP levels were obtained at baseline, 6 and 12 weeks. We used linear mixed models to examine the association between change in PADP and change in NT-proBNP, adjusting for baseline covariates.

RESULTS: Of 62 patients, the mean age was 66.2 years, and 63% were male. The mean baseline PADP was 21.8 ± 6.4 mmHg, and the mean NT-proBNP was 1844.6 ± 2767.7 ρg/mL. The mean change between baseline and averaged 6- and 12-week PADP was -0.4 ± 3.1 mmHg, and the mean change between baseline and averaged 6- and 12-week NT-proBNP was -81.5 ± 878.6 ρg/mL. In adjusted analyses, every two mmHg decrease in PADP was associated with an NT-proBNP reduction of 108.9 ρg/mL (95% CI -4.3-222.0, p = 0.06).

CONCLUSION: We observed that short-term reductions in ambulatory PADP appear to be associated with decreases in NT-proBNP. This finding may provide additional clinical context when tailoring treatment for patients with heart failure.