Prognostic Value Of Natriuretic Peptides In Patients With Pheochromocytoma-Induced Catecholamine Cardiomyopathy

To evaluate the prognostic value of atrial and brain natriuretic peptides (ANP and BNP) in patients with adrenal pheochromocytoma (PC)-induced catecholamine cardiomyopathy (CC). A prospective case-control study was conducted from April 2004 to May 2010. Plasma concentrations of ANP and BNP were measured in 132 patients with PC, 75 patients with essential hypertension (EH), and 54 healthy control subjects. After effective antihypertensive therapy, peptide measurements were repeated for patients with PC; laparoscopic adrenalectomy was administered for patients with PC. After surgery, the same procedures were conducted for patients with PC. Patients with CC yielded significantly higher plasma ANP and BNP concentrations than the control subjects, patients with EH, and patients without CC (P < 0.01). The control subjects, patients with EH, and patients without CC also showed significantly different ANP and BNP concentrations (P < 0.01). Age, tumor size, and disease duration were independent risk factors of CC. Areas under receiver operating characteristic curve of ANP and BNP to predict CC were 0.742 and 0.838, with cutoffs of 148.35 and 451.40 ng/l, respectively. Plasma ANP and BNP concentrations significantly decreased after antihypertensive treatment; these parameters continuously decreased after surgery in patients without CC and patients with CC (P < 0.01). Therefore, the two peptides are efficient predictors of cardiovascular mortality among patients with CC, as revealed by univariate Cox proportional hazard regression analyses confirmed using a multivariate model. Plasma ANP and BNP provide important and independent prognostic information of cardiovascular dysfunction induced by CC.