N-terminal proatrial natriuretic peptide predicts two-year remodelling in patients with acute transmural myocardial infarction.
OBJECTIVE
To evaluate whether baseline N-terminal proatrial natriuretic peptide (Nt-proANP) or Doppler echocardiographic parameters could predict two-year left ventricular remodelling after acute myocardial infarction in patients without heart failure.


RESULTS
Seventy-one patients were followed with Doppler echocardiographic examinations at baseline, 3 months, 1 and 2 years, and Nt-proANP was measured at baseline and 3 months. After 2 years there was a significant increase in end-diastolic volume index of 11% ( p=0.006 ) and end-systolic volume index of 14% ( p=0.03 ), and no change in ejection fraction. This remodelling was confined to 12 patients (17%) with a significant increase in end-diastolic volume index above 20 ml/m(2). Baseline Nt-proANP ( p<0.0005 ), 3-month changes in end-diastolic volume index ( p=0.007 ), and 3-month E/A ratio ( p=0.014 ) were independent positive predictors for two-year changes in end-diastolic volume index. Two-year dilatation above 20 ml/m2 was predicted by baseline Nt-proANP (p=0.014) and maximal velocity of systolic pulmonary venous flow ( p=0.034 ).


CONCLUSIONS
Seventeen percent of patients with transmural myocardial infarction and no baseline heart failure experienced a significant left ventricular dilatation at 2 years, and this was best predicted by baseline Nt-proANP. Unstructured abstract Seventy-one patients with acute myocardial infarction and no heart failure were followed for two years in an observational Doppler echocardiographic study. There was a significant increase in end-diastolic volume index of 11% ( p=0.006 ) and end-systolic volume index of 14% (p=0.03), but no change in ejection fraction after two years. Nt-proANP was the strongest independent predictor of two-year changes in end-diastolic volume index and of an increase in end-diastolic volume index above 20 ml/m2 after two years.
Hole
Torstein
T
Section of Cardiology, Medical Department, Alesund Hospital, N-6026, Alesund, Norway. torstein.hole@helse-sunnmore.no
Hall
Christian
C
Skaerpe
Terje
T
D009320:Atrial Natriuretic Factor / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000000981:diagnostic imaging; D011498:Protein Precursors / Q000097:blood*; D020257:Ventricular Remodeling / Q000502:physiology*
D015415:Biomarkers; C099254:N-terminal proatrial natriuretic peptide; D011498:Protein Precursors; D009320:Atrial Natriuretic Factor