American journal of physiology. Heart and circulatory physiology, Volume 329, Issue 5, 10 2 2025, Pages H1414-H1421 Bone morphogenetic protein 10: clinical correlates and risk of incident atrial fibrillation. Suthahar N, Yap SC, de Vries AAF, Damman K, Fabritz L, Bakker SJL, Gansevoort RT, Kirchhof P, Rienstra M, de Boer RA
Bone morphogenetic protein-10 (BMP10), a protein predominantly secreted by atrial cardiomyocytes, has emerged as a promising biomarker in patients with atrial fibrillation (AF) and as a marker of atrial stress in patients with heart failure. Its clinical correlates in community-dwelling adults and its association with incident AF remain unexplored. BMP10 was measured in 5,883 participants from the Prevention of Renal and Vascular End-stage Disease (PREVEND) community-based cohort (mean age 53.6 yr; 51.5% females). The mean BMP10 concentration was 2.20 ± 0.43 ng/mL. In multivariable linear regression analyses, the strongest positive correlates of BMP10 were female sex [standardized beta-(Sβ): 0.34], high-density lipoprotein cholesterol (HDL-C; Sβ: 0.16), total cholesterol (Sβ: 0.13), and N-terminal pro-B-type natriuretic peptide (NT-proBNP; Sβ: 0.13). The strongest negative correlates were relative fat mass (Sβ: -0.21), C-reactive protein (CRP; Sβ: -0.16), and estimated glomerular filtration rate (eGFR; Sβ: -0.13); P for all < 0.001. BMP10 was not significantly associated with prevalent hypertension, myocardial infarction, stroke, or heart failure. Over a median follow-up of 6.4 years, 154 participants (2.6%) developed incident AF, corresponding to 4.2 cases per 1,000 person years. In a multivariable Cox-regression model, higher BMP10 levels were significantly associated with incident AF (Hazard ratio per 1SD increase: 1.58; 95%CI: 1.23-2.04). In summary, among community-dwelling adults, BMP10 levels are higher in women, positively associated with HDL-C and NT-proBNP, and inversely associated with fat mass, inflammation, and kidney function. Although not linked to prevalent cardiovascular disease, higher BMP10 levels are independently associated with incident AF.NEW & NOTEWORTHY This is the first population-based study of circulating bone morphogenetic protein 10 (BMP10), a heart-specific protein mainly secreted by atrial cardiomyocytes. In over 5,800 community-dwelling adults, BMP10 showed distinct physiological and pathophysiological correlates, including higher levels in women, an inverse association with fat mass and inflammation (CRP), and a positive association with incident atrial fibrillation. These findings represent an important first step toward understanding the role of BMP10 in atrial biology and disease.
