title: N-terminal proatrial natriuretic peptide correlates with systolic dysfunction and left ventricular filling pattern in patients with idiopathic dilated cardiomyopathy.
abstract: OBJECTIVE
  To investigate the diastolic Doppler filling pattern in patients with idiopathic dilated cardiomyopathy and its relation to N-terminal pro-atrial natriuretic peptide (NT-pro-ANP).
  
  
  METHODS
  32 patients (26 male, six female) with idiopathic dilated cardiomyopathy were investigated. All were in sinus rhythm. Conventional M mode echocardiography and Doppler echocardiography was done in each patient. Pulsed wave Doppler inflow signals were obtained and the following variables were measured: maximum E wave, maximum A wave, E/A ratio, E wave deceleration time, A wave deceleration time. NT-pro-ANP was measured using radioimmunoassay.
  
  
  RESULTS
  Mean (SD) left ventricular ejection fraction was 34 (7)% and mean left ventricular end diastolic diameter on M mode echocardiography was 69 (7) mm. Left ventricular filling indices were as follows: maximum E wave velocity, 0.86 (0.22) m/s; maximum A wave velocity, 0.71 (0.24) m/s; E/A ratio, 1.41 (0.65). Mean E wave deceleration time was 140 (50) ms; mean A wave deceleration time was 100 (20) ms. In a stepwise forward regression model, NT-pro-ANP correlated significantly with left atrial diameter (r = 0.603; p < 0. 001), left ventricular ejection fraction (r = -0.758; p < 0.001), and Doppler derived E/A ratio (r = 0.740; p < 0.001).
  
  
  CONCLUSIONS
  In patients with idiopathic dilated cardiomyopathy there is a relation between NT-pro-ANP and both systolic and diastolic variables. In a multivariate model NT-pro-ANP correlated with left atrial diameter, left ventricular ejection fraction, and Doppler derived E/A ratio on transmitral inflow.
authors.affiliation: Department of Internal Medicine, Division of Cardiology, Karl-Franzens University, Auenbruggerplatz 15, A-8036 Graz, Austria. friedrich.fruhwald@kfunigraz.ac.at
authors.forename: F M
authors.initials: FM
authors.lastname: Fruhwald
authors.forename: A
authors.initials: A
authors.lastname: Fahrleitner
authors.forename: N
authors.initials: N
authors.lastname: Watzinger
authors.forename: H
authors.initials: H
authors.lastname: Dobnig
authors.forename: M
authors.initials: M
authors.lastname: Schumacher
authors.forename: R
authors.initials: R
authors.lastname: Maier
authors.forename: R
authors.initials: R
authors.lastname: Zweiker
authors.forename: G
authors.initials: G
authors.lastname: Leb
authors.forename: W
authors.initials: W
authors.lastname: Klein
mesh_terms: D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002311:Cardiomyopathy, Dilated / Q000097:blood / Q000000981:diagnostic imaging*; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011498:Protein Precursors / Q000097:blood*; D012044:Regression Analysis; D013318:Stroke Volume; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000000981:diagnostic imaging*
chemical_list: D015415:Biomarkers; C099254:N-terminal proatrial natriuretic peptide; D011498:Protein Precursors; D009320:Atrial Natriuretic Factor