Document Detail


B-type natriuretic peptide and tissue doppler for predicting symptoms on treadmill exercise in apparently asymptomatic aortic stenosis.
MedLine Citation:
PMID:  20099699     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIM OF THE STUDY: Exercise-induced symptoms are associated with early changes in left ventricular (LV) function. Blood B-type natriuretic peptide (BNP) and tissue Doppler indices (tDi) also reflect early LV dysfunction, and may therefore predict the development of symptoms. The study aim was to compare BNP levels and tDi for predicting symptoms on treadmill exercise in apparently asymptomatic aortic stenosis (AS). METHODS: A total of 65 patients (mean age 66 years) with an aortic effective orifice area <1.5 cm2 who were asymptomatic on formal questioning, underwent transthoracic echocardiography, measurement of blood BNP level, and exercise testing using a modified Bruce protocol. RESULTS: A blood BNP level >58 pg/ml had a sensitivity of 86% and specificity of 64% (AUC = 0.81) for the development of symptoms on exercise testing. The combined tDi index of peak systolic shortening velocity <8 cm/s and E/Ea >15 had a sensitivity of 52% and specificity of 73%. In patients with no symptoms on exercise, 27% with a blood BNP level >58 pg/ml compared to 7% with a level < or =58 pg/ml developed symptoms during follow up. CONCLUSION: The study results suggested that patients with a blood BNP level < or =58 pg/ml can be seen up to one year, while those with a BNP level >58 pg/ml required exercise testing and a more frequent follow up. The combined tissue Doppler indices gave a similar, but less accurate, stratification.
Authors:
Ronak Rajani; Helen Rimington; John Chambers
Related Documents :
17617309 - Elevated left ventricular filling pressure after maximal exercise predicts increased pl...
191849 - Evidence that the preoptic region is a receptive site for the dipsogenic effects of ang...
22436839 - Trunk muscle activation during stabilization exercises with single and double leg support.
22813079 - Sport and exercise medicine and the olympic health legacy.
22254619 - Innovative self management system for guided cardiac rehabilitation.
1943729 - Effects of cocaine, exercise, and resting conditions on plasma corticosterone and catec...
11069809 - Quadriceps and diaphragmatic function after exhaustive cycle exercise in the healthy el...
23009619 - Temperature and heart rate responses to exercise following mild traumatic brain injury.
21178129 - Older type 2 diabetic males do not exhibit abnormal pulmonary oxygen uptake and muscle ...
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of heart valve disease     Volume:  18     ISSN:  0966-8519     ISO Abbreviation:  J. Heart Valve Dis.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2010-01-26     Completed Date:  2010-03-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9312096     Medline TA:  J Heart Valve Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  565-71     Citation Subset:  IM    
Affiliation:
Valve Study Group, Guy's and St. Thomas' Hospital, London, UK.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Algorithms
Aortic Valve Stenosis / diagnosis*,  mortality,  ultrasonography
Elasticity Imaging Techniques*
Exercise Test*
Female
Humans
Kaplan-Meiers Estimate
Male
Middle Aged
Natriuretic Peptide, Brain / blood*
Predictive Value of Tests
ROC Curve
Risk Assessment
Chemical
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain
Comments/Corrections
Comment In:
J Heart Valve Dis. 2009 Sep;18(5):562-4   [PMID:  20099698 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Complex valve disease: pre-surgical functional capacity evaluation using peak oxygen consumption.
Next Document:  Septic coronary embolism in aortic valvular endocarditis.