{
  "abstract": "Background While cross-sectional BNP and echocardiographic assessments inform heart failure (HF) staging, the value of serial measures in identifying subclinical progression or regression in preclinical HF remains underexplored.Objective To assess longitudinal changes in cardiac structure, function, and BNP levels across distinct preclinical HF trajectories to better understand dynamic disease evolution.Methods We analysed longitudinal BNP and echocardiographic data from 1,425 participants in the STOP-HF cohort. Patients were grouped into six trajectory categories (A-A, A-B, A-C, B-A, B-B, B-C) based on HF staging at baseline and follow-up (mean 5.4 years). Annualised changes in EF, LVEDd, LVMI, LAVI, E/e′, and BNP were calculated.Results Serial echocardiographic measurements across follow-up visits revealed distinct patterns of structural and functional cardiac change. Among participants who transitioned from Stage A to Stage B or C, annualised increases were observed in LVMI, LAVI, and E/e′, while EF declined modestly. Conversely, individuals who transitioned from Stage B to Stage A showed stabilisation or modest regression of adverse echocardiographic indices ( table 1) BNP concentrations were also measured at two time points to assess biochemical progression across HF stage trajectories. Among patients who remained stable (A-A), median BNP increased modestly (12.6 to 17.1 pg/mL), while more pronounced rises were observed among those progressing to advanced stages, particularly B-C transitions (83.0 to 220.0 pg/mL) (table 2)Conclusions Serial BNP and echocardiographic monitoring reveal progressive and regressive trends well before symptomatic HF develops. These findings challenge reliance on single-timepoint risk models and suggest that periodic longitudinal surveillance could identify at-risk individuals earlier, enabling preventive interventions before irreversible damage occurs. Further studies should prioritise establishing optimal intervals and composite biomarker-imaging algorithms for early HF detection.Abstract 37 Table 1Changes in echocardiographic parameters across preclinical heart failure stage transitionsAbstract 37 Table 2Changes in BNP concentrations across preclinical heart failure stage transitions",
  "authors": [
    {
      "affiliations": [
        "St Vincents University Hospital, Dublin, Ireland"
      ],
      "name": "A Moore"
    },
    {
      "affiliations": [
        "St Vincents University Hospital, Dublin, Ireland"
      ],
      "name": "M Barrett"
    },
    {
      "affiliations": [
        "St Vincents University Hospital, Dublin, Ireland"
      ],
      "name": "J Gallagher"
    },
    {
      "affiliations": [
        "St Vincents University Hospital, Dublin, Ireland"
      ],
      "name": "M Ledwidge"
    },
    {
      "affiliations": [
        "St Vincents University Hospital, Dublin, Ireland"
      ],
      "name": "K McDonald"
    }
  ],
  "title": "37 Signals in motion: longitudinal echocardiographic and BNP trajectories across preclinical heart failure stages",
  "uid": "7e112cab-4516-515d-8323-95add69e788d"
}