Document Detail


The relationship between B-type natriuretic peptide levels and echocardiographic parameters in patients with heart failure admitted to the emergency department.
MedLine Citation:
PMID:  20382614     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Brain natriuretic peptide (BNP) is a peptide, which has recently been used in the differential diagnosis and follow-up of patients with heart failure. Our aim in the present prospective and diagnostic designed study is to investigate the role of BNP in determining the etiology of dyspnea and to evaluate its relation with newer echocardiographic parameters. METHODS: Thirty-four patients presenting to the emergency department with dyspnea and fulfilling the Framingham criteria for heart failure were included in the study. Blood samples were obtained in the first hour of presentation for measurement of BNP levels from all patients. Detailed transthoracic two-dimensional, Doppler and tissue Doppler echocardiographic studies were then performed within 24 hours of presentation. Statistical analyses were performed using Student's t-test for independent samples, Mann Whitney U test and Pearson or Spearman correlation tests. RESULTS: Plasma BNP levels were found to be significantly correlated with left ventricular end-systolic and end-diastolic diameter, left atrial diameter and the degree of mitral insufficiency (r=0.46, p=0.007; r=0.39, p=0.02; r=0.32, p=0.065; r=0.50, p=0.014, respectively). A significant inverse correlation was observed between plasma BNP levels and left ventricular ejection fraction (r=-0.5, p=0.003). When the patients were grouped according to their BNP levels, the mean ejection fraction of the group with BNP levels below median (578 pg/l) was 60.65+/-13.84%, whereas the mean ejection fraction of the group with BNP levels of 578 pg/l or above (BNP 2) was 49.41+/-15.26% (p=0.027). Out of parameters reflecting left ventricular diastolic functions, only transmitral Epeak/Apeak ratio was found to be significantly associated with BNP levels (r=0.4, p=0.05). Tissue Doppler study revealed significant correlations between BNP levels and right ventricular basal and midsystolic velocities (r=-0.507, p=0.008; r=-0.562, p=0.005, respectively) while none of the left ventricular tissue velocities displayed significant correlation with BNP values. CONCLUSION: Plasma BNP levels are found to be significantly associated with conventional echocardiographic parameters reflecting left ventricular systolic and diastolic functions and tissue Doppler velocities reflecting right ventricular functions. Our findings are in agreement with the notion that plasma BNP levels are beneficial in the differential diagnosis of patients admitted to emergency service with acute dyspnea.
Authors:
Evvah Karakili?; Alper Kepez; G?lcan Abali; Figen Co?kun; Mahir Kunt; Lale Tokg?zo?lu
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology     Volume:  10     ISSN:  1308-0032     ISO Abbreviation:  Anadolu Kardiyol Derg     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-12     Completed Date:  2010-05-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101095069     Medline TA:  Anadolu Kardiyol Derg     Country:  Turkey    
Other Details:
Languages:  eng     Pagination:  143-9     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Hacettepe University, Ankara, Turkey. evvah@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Biological Markers / blood
Diagnosis, Differential
Dyspnea / blood,  diagnosis,  physiopathology,  ultrasonography
Echocardiography, Doppler
Echocardiography, Doppler, Color
Emergency Medical Services
Female
Heart Failure / blood*,  diagnosis*,  physiopathology,  ultrasonography
Humans
Male
Natriuretic Peptide, Brain / blood*
Stroke Volume
Ventricular Function, Left / physiology*
Ventricular Function, Right / physiology*
Chemical
Reg. No./Substance:
0/Biological Markers; 114471-18-0/Natriuretic Peptide, Brain

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