Document Detail

Combining tissue Doppler echocardiography and B-type natriuretic peptide in the evaluation of left ventricular filling pressures: review of the literature and clinical recommendations.
MedLine Citation:
PMID:  17932575     Owner:  NLM     Status:  MEDLINE    
Tissue Doppler imaging is an echocardiographic technique that directly measures myocardial velocities. Diastolic tissue Doppler velocities reflect myocardial relaxation, and in combination with conventional Doppler measurements, ratios (transmitral early diastolic velocity/mitral annular early diastolic velocity [E/Ea]) have been developed to noninvasively estimate left ventricular (LV) filling pressure. Consequently, mitral E/Ea can help to establish the presence of clinical congestive heart failure in patients with dyspnea. However, E/Ea has a significant 'gray zone', and is not well validated in nonsinus rhythm and mitral valve disease. B-type natriuretic peptide (BNP) is a protein released by the ventricles in the presence of myocytic stretch, and has been correlated to LV filling pressure and, independently, to other cardiac morphological abnormalities. In addition, BNP is significantly affected by age, sex, renal function and obesity. Given its correlation with multiple cardiac variables, BNP has high sensitivity, but low specificity, for the detection of elevated LV filling pressures. Taking into account the respective strengths and limitations of BNP and mitral E/Ea, algorithms combining them can be used to more accurately estimate LV filling pressures in patients presenting with dyspnea.
Hisham Dokainish
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  23     ISSN:  0828-282X     ISO Abbreviation:  Can J Cardiol     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-10-12     Completed Date:  2007-11-30     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  983-9     Citation Subset:  IM    
Baylor College of Medicine, Houston, TX 77030, USA.
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MeSH Terms
Dyspnea / etiology
Echocardiography, Doppler / methods
Heart Failure / complications,  diagnosis*,  physiopathology*
Natriuretic Peptide, Brain / analysis
Sensitivity and Specificity
Ventricular Dysfunction, Left / blood,  ultrasonography*
Ventricular Function, Left*
Ventricular Pressure*
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain

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

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