Predictive importance of left ventricular myocardial stiffness for the prognosis of patients with congestive heart failure
| Autor: | Satoshi Watanabe, Hideyuki Takaoka, Daisuke Ogasawara, Hiromasa Otake, Junya Shite, Toshiro Shinke, Takahiro Sawada, Daisuke Matsumoto, Mitsuhiro Yokoyama, Yusuke Tanino, Ken-ichi Hirata |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Myocardial stiffness medicine.drug_class Diastole Hemodynamics Heart failure Ventricular Function Left Internal medicine Natriuretic Peptide Brain medicine Clinical endpoint Natriuretic peptide Humans Aged Aged 80 and over business.industry Proportional hazards model Middle Aged Prognosis medicine.disease Confidence interval Natriuretic peptides brain Acute Disease Cardiology Female Cardiology and Cardiovascular Medicine business Biomarkers Forecasting |
| Zdroj: | Journal of Cardiology. 58:245-252 |
| ISSN: | 0914-5087 |
| DOI: | 10.1016/j.jjcc.2011.07.005 |
| Popis: | Summary Objectives This study was designed to determine the prognostic importance of left ventricular (LV) myocardial stiffness, a hemodynamic index which is closely related to B-type natriuretic peptide (BNP) concentration in patients with congestive heart failure (CHF). Background While elevated BNP, an abnormality of cardiac neurohormones, is known to be an independent marker of death or re-admission, it remains to be clarified whether there is also a strong predictor directly related to cardiac dysfunction. Methods LV performance variables and stress–strain analyses including diastolic myocardial stiffness constant (Km) were obtained from 37 patients with initial CHF by the combined simultaneous measurement of echocardiographic and hemodynamic data. Survivors were monitored for a mean of 23 months, with the main endpoint being combined death or first re-admission for CHF. Results Ten patients (27%) were primary endpoint cases. Both Km and plasma BNP levels were higher in the event than in the event-free group. By Cox proportional hazards analysis, Km ≥ 4.0 was identified as the only variable with significant and independently incremental predictive power to affect the primary endpoint (adjusted hazard ratio = 7.354, 95% confidence interval 1.379–39.232, p = 0.02). Conclusions In patients with CHF, increased myocardial stiffness may have greater prognostic significance compared to other conventional predictors. Increased myocardial stiffness may be considered to be an important prognostic factor independent of the loading conditions. |
| Databáze: | OpenAIRE |
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