Document Detail


N-terminal proBNP levels in patients with Chagas disease: a marker of systolic and diastolic dysfunction of the left ventricle.
MedLine Citation:
PMID:  16651029     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: NT-proBNP levels are known to be elevated in systolic and diastolic dysfunction. Doppler indices of diastolic dysfunction (DD) have been shown to have prognostic value in patients with Chagas' cardiomyopathy (CC). However, the additional value of NT-proBNP levels in further stratifying these patients according to DD has not been established. This study analyzed the correlation of N-terminal proBNP (NT-proBNP) levels with systolic and diastolic function in patients with CC. METHODS AND RESULTS: NT-proBNP levels were measured in 59 patients with dilated cardiomyopathy due to Chagas disease without other systemic illness that were studied by Doppler echocardiography, including left atrial volume (LAV) calculation and tissue Doppler evaluation of LV longitudinal function. Univariate analysis showed a strong correlation of NT-proBNP values with LVEF (r=-0.733, p<0.001) and a weak correlation with most Doppler echocardiographic parameters of diastolic function. On a multivariate analysis, LVEF and LAV volume emerged as correlating with elevated levels of the NT-proBNP. Patients with restrictive filling pattern (n=10), when compared to other patterns of DD, (n=49), showed a lower LVEF (25.4+/-6.4% vs. 39.8+/-9.4, p<0.001), a larger LAV (50.1+/-17.2 vs. 37.7+/-15.6 ml/m(2), p=0.004) and higher NT-proBNP levels (median+/-IQR: 3488+/-3056 vs. 492+/-700 pg/dl, p<0.001). A marked elevated concentration of NT-proBNP (> or =800 pg/ml) had a sensitivity of 90.0%, specificity of 70.5%, positive predictive value of 40.9% and negative predictive value of 96.9% for detecting a restrictive filling pattern. CONCLUSION: In patients with CC, NT-proBNP augmentation is a marker of LV dysfunction, with higher levels correlating with the more severe forms of both systolic and diastolic dysfunction.
Authors:
Marcia M Barbosa; Maria do Carmo P Nunes; Antônio Luiz P Ribeiro; Marselha M Barral; Manoel Otávio C Rocha
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-05-02
Journal Detail:
Title:  European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology     Volume:  8     ISSN:  1525-2167     ISO Abbreviation:  Eur J Echocardiogr     Publication Date:  2007 Jun 
Date Detail:
Created Date:  2007-05-07     Completed Date:  2007-10-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100890618     Medline TA:  Eur J Echocardiogr     Country:  England    
Other Details:
Languages:  eng     Pagination:  204-12     Citation Subset:  IM    
Affiliation:
Ecocenter, Hospital Socor, Av. Contorno 10500, 30110-140 Belo Horizonte, MG, Brazil.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Biological Markers
Cardiomyopathy, Dilated / blood,  diagnosis*,  ultrasonography
Chagas Disease / blood,  diagnosis*,  ultrasonography
Diastole
Female
Heart Failure / diagnosis*,  ultrasonography
Humans
Male
Middle Aged
Natriuretic Peptide, Brain / blood*
Peptide Fragments / blood*
Prospective Studies
Stroke Volume
Systole
Time Factors
Ventricular Dysfunction, Left / blood,  diagnosis*,  ultrasonography
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain

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