Prognostic Value of N-Terminal Pro–Type-B Natriuretic Peptide and Doppler Left Ventricular Diastolic Variables in Patients With Chronic Systolic Heart Failure Stabilized by Therapy

• Published in: The American journal of cardiology 2008-08, Vol.102 (4), p.463-468
• Main Authors: Dini, Frank Lloyd, MD, Conti, Umberto, MD, Fontanive, Paolo, MD, Andreini, Diana, MD, Panicucci, Erica, PhD, De Tommasi, Salvatore Mario, MD
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Cardiology; Cardiology. Vascular system; Cardiovascular; Cardiovascular system; Chronic Disease; Diastole; Female; Heart; Heart failure; Heart Failure - blood; Heart Failure - diagnostic imaging; Heart Failure - physiopathology; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Heart Septum - pathology; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Mitral Valve - pathology; Multivariate analysis; Natriuretic Peptide, Brain - blood; Peptide Fragments - blood; Peptides; Predictive Value of Tests; Prognosis; Prospective Studies; Risk Assessment; ROC Curve; Sensitivity and Specificity; Stroke Volume; Studies; Systole; Ultrasonic imaging; Ultrasonic investigative techniques; Ultrasonography, Doppler; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - physiopathology
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2008.03.083

Prognostication of patients with chronic heart failure (HF) stabilized by therapy may be difficult. Therefore, the aim was to evaluate whether combined assessment of plasma N-terminal pro-B natriuretic peptide (NT-pro-BNP) and Doppler left ventricular (LV) diastolic variables was relevant to the prognosis of patients with stable HF. Outpatients with LV systolic HF (ejection fraction ≤45%), classified using clinical criteria as decompensated (n = 94) and stable HF (n = 219), underwent a complete Doppler echocardiographic study. NT-pro-BNP was measured together with mitral wave velocities, E wave deceleration time, and tissue Doppler early septal annular velocity. Median follow-up was 22 months. Freedom from all-cause mortality or HF hospitalization at 24 months was worst (44%) in patients with decompensated HF, intermediate (58%) in patients with stable HF with NT-pro-BNP higher than the median (>1,129 pg/ml), and best (92%) in patients with lower NT-pro-BNP (log-rank p 1,129 pg/ml (hazard ratio [HR] 2.84, p = 0.003), E wave deceleration time