Background:
Secretoneurin is a bioactive neuropeptide composed of 33 amino acids, expressed in neuroendocrine, endocrine, and neuronal tissues, and internalized by cardiomyocytes. It has recently been investigated as a potential biomarker in various clinical conditions, including sepsis, hypoxic brain injury, arrhythmia, chronic heart failure, and aortic valve stenosis prior to surgical aortic valve replacement (SAVR). The present study aimed to evaluate the prognostic value of Secretoneurin in patients with severe aortic stenosis (AS) before transcatheter aortic valve implantation (TAVI).
Materials and Methods:
Plasma samples were obtained from 160 patients prior to TAVI. Long-term follow-up (median duration: 32 months) was performed to assess all-cause mortality and a composite endpoint of mortality and congestive heart failure. During follow-up, 45 patients (28%) died, and 64 (40%) reached the composite endpoint.
Results:
Baseline NT-proBNP concentrations were significantly higher in patients with classical low-flow, low-gradient AS compared with other severe AS phenotypes (p < 0.01). In contrast, baseline Secretoneurin levels did not differ significantly between groups (p = n.s.).
Elevated baseline levels of both Secretoneurin and NT-proBNP were significant predictors of all-cause mortality and the combined endpoint in Kaplan–Meier analysis (each p < 0.05). In multivariable Cox regression analysis, Secretoneurin and stroke volume index (SVi) remained significant predictors for both endpoints (each p < 0.05), whereas NT-proBNP, creatinine, and other clinical variables were not significant (each p = n.s.).
Conclusion:
Baseline Secretoneurin levels, and to a lesser extent NT-proBNP, provide significant prognostic information for all-cause mortality in patients with severe aortic stenosis undergoing TAVI. Secretoneurin may represent a novel biomarker for risk stratification in this patient population.
