Document Detail


Restrictive filling pattern predicts pulmonary hypertension and is associated with increased BNP levels and impaired exercise capacity in patients with heart failure.
MedLine Citation:
PMID:  17975752     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Left ventricular (LV) diastolic dysfunction is a common finding in patients with systolic heart failure (HF). Severe diastolic dysfunction, which is defined as LV restrictive filling pattern (RFP), is associated with more severe HF, increased sympathetic activity and reduced exercise capacity. It has also been shown to be a predictor of lower survival rate in patients with HF. AIM: To evaluate associations between LV diastolic RFP and BNP levels, systolic pulmonary pressure and exercise capacity in patients with clinically stable HF. METHODS: In 56 patients with HF and low LVEF a standard echocardiographic study and cardiopulmonary exercise test were performed. Levels of BNP using RIA method were also measured. RESULTS: Restrictive filling pattern (E/A >2 or 1< E/A <2 and DTE < or =130 ms) was diagnosed in 26 patients. The RFP group showed increased levels of BNP (90.6+/-66 vs. 50.4+/-61 pg/ml; p=0.003), significantly reduced peak VO2 (15.4+/-4.1 vs. 17.8+/-4.9 ml/kg/min; p=0.046), increased VE/VCO2 slope (36.3+/-5.9 vs. 31.9+/-6.3; p=0.01), and elevated PASP (pulmonary artery systolic pressure measured by echo-Doppler) (49.3+/-13.8 vs. 37.2+/-12.6 mmHg; p=0.02). Prevalence of pulmonary hypertension was significantly higher in the RFP group. A significant correlation between DTE and peak VO2 (r=0.28; p=0.02) and inverse correlations between DTE and BNP levels (r=-048; p=0.003), VE/VCO2 slope (r=-0.35; p=0.02) and PASP (r=-0.39; p=0.03) were found. In logistic regression analysis only RFP was independently associated with pulmonary hypertension. CONCLUSIONS: The restrictive filling pattern is an independent predictor of pulmonary hypertension and is associated with increased BNP levels and worse result of cardiopulmonary exercise test.
Authors:
Ewa Straburzyńska-Migaj; Andrzej Szyszka; Olga Trojnarska; Andrzej Cieśliński
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Kardiologia polska     Volume:  65     ISSN:  0022-9032     ISO Abbreviation:  Kardiol Pol     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-11-02     Completed Date:  2008-04-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376352     Medline TA:  Kardiol Pol     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  1049-55; discussion 1056-7     Citation Subset:  IM    
Affiliation:
1st Department and Chair of Cardiology, Poznan University of Medical Sciences, Poland. ewa.migaj-straburzynska@sk1.am.poznan.pl
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MeSH Terms
Descriptor/Qualifier:
Adult
Diastole
Echocardiography
Exercise Test
Exercise Tolerance / physiology
Female
Heart Failure / blood,  physiopathology*
Humans
Hypertension, Pulmonary / blood*,  diagnosis*,  physiopathology
Male
Middle Aged
Natriuretic Peptide, Brain / blood*
Predictive Value of Tests
Stroke Volume
Ventricular Dysfunction, Left / blood,  physiopathology*,  ultrasonography
Chemical
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain

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