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B-type natriuretic peptide and impedance cardiography at the time of routine echocardiography predict subsequent heart failure events.
MedLine Citation:
PMID:  19181293     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Detection of heart failure (HF) in stable outpatients can be difficult until an overt event occurs. This study sought to determine whether the combination of B-type natriuretic peptide (BNP) and impedance cardiography (ICG) could be used in a nonacute clinical setting to risk stratify and predict HF-related events in stable outpatients. METHODS AND RESULTS: Patients undergoing routine outpatient echocardiography underwent ICG and BNP testing and were followed for one year for HF-related events (Emergency Department [ED] visit or hospitalization due to HF or all-cause death). A total of 524 patients were analyzed, resulting in 57 HF-related events; 16 ED visits, 17 hospitalizations, and 24 all-cause deaths. Using Cox regression analyses, BNP and systolic time ratio index (STRI) by ICG proved to be the strongest predictors of future HF-related events. Patients with a BNP >100 pg/ml and STRI >0.45 sec(-1) had a significantly lower event-free survival rate than those with a high BNP and low STRI (67% versus 89%, P=.001). In patients with LV dysfunction only, if both BNP and STRI values were high, the relative risk of a HF-related event increased by 12.5 (95 % C.I. 4.2-36.7), when compared with patients with a low BNP and low STRI (P<.001). CONCLUSIONS: In a nonacute clinical setting, both BNP and ICG testing can provide unique predictive power of long-term HF-related events in a stable cohort of patients with and without LV dysfunction.
Authors:
Luis R Castellanos; Vikas Bhalla; Susan Isakson; Lori B Daniels; Meenakshi A Bhalla; Jeannette P Lin; Paul Clopton; Nancy Gardetto; Max Hoshino; Albert Chiu; Robert Fitzgerald; Alan S Maisel
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-12-02
Journal Detail:
Title:  Journal of cardiac failure     Volume:  15     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  41-7     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Department of Medicine Veteran's Affairs San Diego Healthcare System, La Jolla, CA 92161, USA.
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