ORIGINAL ARTICLE
Open Access

Prognostic Value of NT-proBNP Dynamics and Echocardiographic Parameters in Patients with Non-Ischemic Dilated Cardiomyopathy

Ramon Paolo T. Navarro1, Angelica Mae L. Cruz2, Maria Isabel D. Santos ORCID3

¹ Division of Cardiology, University of the Philippines Manila, Taft Avenue, Philippines.
² Center for Molecular and Cell Biology, St. Luke’s Medical Center–Quezon City, Philippines.
³ Department of Pathology and Laboratory Medicine, University of Santo Tomas Hospital, Philippines

DOI: 10.18081/ajbm.2025.3.163

Publication History: Received 14 April 2025, Revised 03 May 2025, Accepted 12 June 2025, Available online 11 July 2025
Copyright: © 2025 Siddiqui, et al. This is an open-access article under a Creative Commons license (CC BY 4.0).

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ABSTRACT

Background: Non-ischemic dilated cardiomyopathy (NIDCM) is characterized by progressive ventricular dilation and systolic dysfunction despite optimized therapy. Identifying reliable markers that predict outcomes and monitor disease evolution remains a clinical challenge. This study investigated the prognostic significance of serial N-terminal pro–B-type natriuretic peptide (NT-proBNP) changes in relation to echocardiographic remodeling parameters among patients with NIDCM.

Methods: In a prospective cohort of 156 patients with NIDCM, serial NT-proBNP measurements and transthoracic echocardiography were performed at baseline, 12 months, and 24 months. Patients were categorized according to NT-proBNP trajectory: Responders (≥30% reduction), Stable (<30% change), and non-responders (≥30% increase). Echocardiographic indices included left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), and left atrial volume index (LAVI). The composite endpoint was all-cause mortality or heart failure (HF) hospitalization. Kaplan–Meier analysis, multivariable Cox regression, and receiver operating characteristic (ROC) analyses were used to evaluate predictive value.

Results: At 24 months, 38% of patients were classified as responders, 34% as stable, and 28% as non-responders. Responders exhibited significant improvement in LVEF (from 33.2 ± 6.7% to 44.5 ± 8.2%, p < 0.001) and GLS (from −9.3 ± 2.5% to −12.7 ± 3.1%, p < 0.001), accompanied by reductions in LAVI and pulmonary pressures. A ≥30% NT-proBNP decline independently predicted reduced risk of the composite endpoint (HR 0.41; 95% CI 0.25–0.69; p < 0.001). The integrated NT-proBNP + echocardiographic model achieved superior discrimination compared with NT-proBNP alone (AUC 0.86 vs 0.74, p = 0.004).

Conclusion: Dynamic reductions in NT-proBNP are closely associated with echocardiographic evidence of reverse remodeling and improved clinical outcomes in NIDCM. The combination of serial biomarker assessment and imaging parameters enhances risk stratification beyond either modality alone. This multimodal approach may facilitate personalized, response-guided management in chronic non-ischemic cardiomyopathy.

Keywords: NT-proBNP; Echocardiography; Global longitudinal strain; Non-ischemic dilated cardiomyopathy

Recommended Citation

Navarro RP, Cruz AM, Santos MI. Prognostic Value of NT-proBNP Dynamics and Echocardiographic Parameters in Patients with Non-Ischemic Dilated Cardiomyopathy. Advanced Journal of Biomedicine & Medicine. 2025;13(3):163-178. doi:10.18081/ajbm.2025.3.163

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This work is licensed under a Creative Commons Attribution 4.0 International License.

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2025 Vol 13, Issue 3 Pages 163-178

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Ayesha Siddiqui, Muhammad Imran Khan, Samina Gul (2025). Refractive Errors and Amblyopia among School-Age Children in south Pakistan: A Population-Based Study. Advanced Journal of Biomedicine & Medicine, 13(2), 131-144. https://doi.org/ 10. 10.18081/ajbm/2025.2/131
Ayesha Siddiqui, Muhammad Imran Khan, Samina Gul. "Refractive Errors and Amblyopia among School-Age Children in south Pakistan: A Population-Based Study." Advanced Journal of Biomedicine & Medicine, vol. 13, no. 2, 2025, pp. 131-144. DOI: 10. 10.18081/ajbm/2025.2/131.
Ayesha Siddiqui, Muhammad Imran Khan, Samina Gul. Refractive Errors and Amblyopia among School-Age Children in south Pakistan: A Population-Based Study. AJBM. 2025;13(2):131-144. DOI: 10. 10.18081/ajbm/2025.2/131. PMID: .
Ayesha Siddiqui, Muhammad Imran Khan, Samina Gul 2025, "Refractive Errors and Amblyopia among School-Age Children in south Pakistan: A Population-Based Study", Advanced Journal of Biomedicine & Medicine, vol. 13, no. 2, pp. 131-144.
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%0 Journal Article %A Ayesha Siddiqui, Muhammad Imran Khan, Samina Gul %T Refractive Errors and Amblyopia among School-Age Children in south Pakistan: A Population-Based Study %J American Journal of Biomedicine %V 13 %N 2 %P 131-144 %D 2025 %R 10. 10.18081/ajbm/2025.2/131 %M
Ayesha Siddiqui, Muhammad Imran Khan, Samina Gul (2025). Refractive Errors and Amblyopia among School-Age Children in south Pakistan: A Population-Based Study. Advanced Journal of Biomedicine & Medicine, 13(2), 131-144. https://doi.org/ 10. 10.18081/ajbm/2025.2/131

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