Document Detail


Prognostic effect of long-axis left ventricular dysfunction and B-type natriuretic peptide levels in asymptomatic aortic stenosis.
MedLine Citation:
PMID:  20102953     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In aortic stenosis (AS), the increased afterload results in progressive structural and functional changes that precede the development of symptoms. We hypothesized that the detection of abnormalities in left ventricular long-axis function could identify patients with asymptomatic AS at increased risk of events. We prospectively examined the outcome of 126 patients with asymptomatic AS who underwent a comprehensive echocardiographic examination, including tissue Doppler imaging. B-type natriuretic peptide (BNP) was measured in all patients. During a median follow-up period of 20.3 + or - 17.8 months, 6 patients died, 8 developed symptoms but did not undergo surgery, and 48 underwent aortic valve replacement. On multivariate Cox regression analysis, the parameters associated with the predefined outcome were gender (p = 0.048), left atrial area index (p = 0.011), systolic annular velocity (p = 0.016), E/Ea ratio (p = 0.024), late diastolic annular velocity (p = 0.023), and BNP (p = 0.012). Using receiver operating characteristics curve analysis, a left atrial area index of > or = 12.4 cm(2)/m(2), systolic annular velocity of < or = 4.5 cm/s, E/Ea ratio >13.8, late diastolic annular velocity of < or = 9 cm/s, and BNP of > or = 61 pg/ml were identified as the best cutoff values to predict events. In conclusion, in asymptomatic AS, tissue Doppler imaging and BNP measurements provide prognostic information beyond that from clinical and conventional echocardiographic parameters.
Authors:
Patrizio Lancellotti; Marie Moonen; Julien Magne; Kim O'Connor; Bernard Cosyns; Emilio Attena; Erwan Donal; Luc Pierard
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Publication Detail:
Type:  Journal Article     Date:  2009-12-02
Journal Detail:
Title:  The American journal of cardiology     Volume:  105     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-27     Completed Date:  2010-03-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  383-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiology, University Hospital Sart Tilman, Li?ge, Belgium. plancellotti@chu.ulg.ac.be
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Aortic Valve Stenosis / blood*,  physiopathology*,  ultrasonography
Biological Markers / blood
Echocardiography, Doppler / methods
Female
Follow-Up Studies
Humans
Male
Middle Aged
Multivariate Analysis
Natriuretic Peptide, Brain / blood*
Prognosis
Proportional Hazards Models
Prospective Studies
Reproducibility of Results
Risk Assessment
Risk Factors
Sensitivity and Specificity
Survival Analysis
Ventricular Dysfunction, Left / blood*,  physiopathology*,  ultrasonography
Chemical
Reg. No./Substance:
0/Biological Markers; 114471-18-0/Natriuretic Peptide, Brain

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