title: Role of B-type natriuretic peptide and echocardiographic indices in predicting the development of acute heart failure following beta-blocker uptitration in chronic heart failure patients with left ventricular systolic dysfunction.
abstract: We evaluated the role of clinical, BNP and echocardiographic left ventricular (LV) indices in predicting the development of acute heart failure (HF) following beta-blocker initiation and uptitration in 50 stable CHF patients with LVEF < 40% and creatininemia < 250 micromol/l. Use of NYHA class alone predicted the development of acute HF decompensation in only 56% and the absence of this event in 93% of patients. Use of echocardiographic indices (systolic PAP < 40 mmHg or E/A ratio < 1.4 or EDT > 145 ms) predicted the absence of acute HF decompensation in 100% of patients. Use of NYHA > 3 combined with BNP > 398 pg/ml or with echocardiographic indices (i.e. systolic PAP > 40 mmHg or E/A > 1.4 or EDT < 145 ms) predicted the development of acute HF decompensation in 100% of patients. In conclusion use of BNP and echocardiographic LV filling pressure indices in combination with NYHA class may predict beta-blocker tolerance more accurately than clinical indices alone in patients with LV systolic dysfunction (LVEF < 40%).
authors.forename: Ahmed
authors.initials: A
authors.lastname: Ben Driss
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Tabet
authors.forename: Philippe
authors.initials: P
authors.lastname: Meurin
authors.forename: Hélène
authors.initials: H
authors.lastname: Weber
authors.forename: Nathalie
authors.initials: N
authors.lastname: Renaud
authors.forename: Anne
authors.initials: A
authors.lastname: Grosdemouge
authors.forename: Claude
authors.initials: C
authors.lastname: Bourmayan
mesh_terms: D000208:Acute Disease; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D002908:Chronic Disease; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010865:Pilot Projects; D011237:Predictive Value of Tests; D013599:Systole; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left
chemical_list: D000319:Adrenergic beta-Antagonists; D020097:Natriuretic Peptide, Brain