Relation of B-type natriuretic peptide early after acute myocardial infarction to left ventricular diastolic function and extent of myocardial damage determined by magnetic resonance imaging.
Early after acute myocardial infarction, the relation between plasma B-type natriuretic peptide (BNP) and extent of myocardial scar formation and diastolic dysfunction remains unclear. In 32 consecutive patients early (5 +/- 3 days) after a first acute myocardial infarction, delayed contrast-enhanced magnetic resonance (MR) imaging was performed to define myocardial scar. Diastolic function was assessed using phase-contrast MR measurements of mitral flow and septal tissue velocities (tissue MR imaging) to estimate left ventricular (LV) filling pressures. MR study was immediately followed by BNP measurement. BNP related to LV ejection fraction (r = -0.52, p = 0.002), extent of myocardial scar (percent delayed hyperenhancement of LV mass, r = 0.49, p = 0.005; transmural index, r = 0.58, p <0.001), and estimated LV filling pressures (ratio of early diastolic mitral flow velocity to early diastolic mitral annular velocity, r = 0.51, p = 0.003). In multivariate analysis, transmural index and early diastolic mitral flow velocity/early diastolic mitral annular velocity were independent predictors of BNP levels (p <0.05, power of 0.99 at alpha = 0.05). In conclusion, among patients with recent myocardial infarction, high BNP levels are independently associated with extent of myocardial scar tissue and estimated LV filling pressures.
Paelinck
Bernard P
BP
Department of Cardiology, University Hospital Antwerp, Edegem, Belgium. bernard.paelinck@uza.be
Vrints
Christiaan J
CJ
Bax
Jeroen J
JJ
Bosmans
Johan M
JM
De Hert
Stefan G
SG
de Roos
Albert
A
Lamb
Hildo J
HJ
D001783:Blood Flow Velocity / Q000502:physiology; D003287:Contrast Media; D003971:Diastole / Q000502:physiology; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000502:physiology; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood / Q000473:pathology*; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011446:Prospective Studies; D013318:Stroke Volume / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000503:physiopathology*
D003287:Contrast Media; D020097:Natriuretic Peptide, Brain; D019786:Gadolinium DTPA