Myocardial tissue Doppler echocardiography and N-terminal B-type natriuretic peptide (NT-proBNP) in diastolic and systolic heart failure
| Autor: | Stephan Eddicks, Vanessa Raab, Adrian C. Borges, Fabian Knebel, Michael Bierbaum, Mark Beling, Gert Baumann, Ingolf Schimke, Sebastian Schattke |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Male lcsh:Diseases of the circulatory (Cardiovascular) system medicine.medical_specialty Diastole Doppler echocardiography Severity of Illness Index Diagnosis Differential Young Adult Tissue Doppler echocardiography Internal medicine Natriuretic Peptide Brain medicine Humans Radiology Nuclear Medicine and imaging cardiovascular diseases Prospective Studies Aged Heart Failure Diastolic Ejection fraction medicine.diagnostic_test E/A ratio business.industry Research Diastolic heart failure Heart General Medicine Middle Aged medicine.disease Echocardiography Doppler Peptide Fragments Pulse pressure ROC Curve Radiology Nuclear Medicine and imaging lcsh:RC666-701 Heart failure Cardiology Female Cardiology and Cardiovascular Medicine business Heart Failure Systolic |
| Zdroj: | Cardiovascular Ultrasound Cardiovascular Ultrasound, Vol 6, Iss 1, p 45 (2008) |
| ISSN: | 1476-7120 |
| Popis: | Background The aim of this prospective study was to assess the diagnostic value of NT-proBNP and the concordance with Tissue Doppler Echocardiography (including strain and longitudinal displacement) in diastolic and systolic heart failure. Methods and results 137 consecutive clinically stable patients were included (42 healthy controls, 43 with diastolic heart failure, 52 with systolic heart failure). In diastolic heart failure, basal septal strain was reduced (-24.8 ± 8.1% vs. controls. -18.5 ± 5.3%, p < 0.0001). In all patients with preserved systolic function, septal basal longitudinal displacement was impaired in patients with increased left-ventricular filling pressures (E/E' < 8: 13.5 mm ± 3.3 mm vs. E/E' > 15: 8.5 mm ± 2.3 mm, p = 0.001) parallel to NT-proBNP elevation (E/E' < 8: 45.8 pg/ml, IQR: 172.5 pg/ml vs. E/E' > 15: 402.0 pg/ml, IQR: 1337.2 pg/ml; p = 0.0007). In ROC analysis, NT-proBNP could detect patients with reduced left ventricular systolic function (LVEF ≥ 55%) with a good diagnostic accuracy. However, the diagnostic accuracy of NT-proBNP to detect diastolic dysfunction was lower. Conclusion Subtle changes of longitudinal myocardial function begin in diastolic heart failure and are further increased in systolic heart failure. In patients with preserved LV function, a complex approach with the integration of multiple parameters including Tissue Doppler echocardiography and NT-proBNP is necessary to classify patients. |
| Databáze: | OpenAIRE |
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