Correlation of the myocardial performance index with plasma B-type natriuretic peptide levels in patients with mitral regurgitation.
OBJECTIVE
The Myocardial performance index (MPI) is an echocardiographic index of combined systolic and diastolic function, calculated as isovolumetric relaxation time plus isovolumetric contraction time divided by ejection time. The aim of this study was to define the correlation of the MPI with plasma B-type natriuretic peptide (BNP) levels and echocardiographic parameters in patients with chronic mitral regurgitation (MR).


METHODS
About 33 patients with at least moderate MR of organic etiology were enrolled to the study. All patients undergone complete 2D and Doppler echocardiography. Plasma BNP levels were studied.


RESULTS
BNP levels in NYHA classes I-III were 9.3 +/- 2.2 pg/ml, 61.3 +/- 12.2 pg/ml, and 199.6 +/- 55.2 pg/ml, respectively (I vs. II P < 0.001, I vs. III P < 0.001 and II vs. III P = 0.004). Myocardial performance index were 0.42 +/- 0.02, 0.49 +/- 0.02, and 0.52 +/- 0.03 in MR patients with NYHA I-III, respectively. MPI was significantly higher in patients with NYHA class III compared to NYHA I (P = 0.001) and NYHA II (P = 0.005). There were no correlations between MPI and left atrial diameter, MR jet area, MR index and systolic pulmonary artery pressure whereas left ventricle (LV) end-systolic volume (r = 0.38), LV end-diastolic volume (LVDV) (r = 0.40), LV ejection fraction (r = -0.59), NYHA class (r = 0.51) and plasma BNP levels (r = 0.67) were strongly correlated. Only independent variable affecting MPI was plasma BNP level (odds ratio [CI]: 2.18[0.002-0.098], P = 0.041).


CONCLUSIONS
MPI is a powerful index in assessing the severity of left ventricular function and symptom severity in patients with MR. Plasma BNP is an independent predictor of MPI where both parameters assess combined systolic and diastolic LV function, effectively.
Sayar
Nurten
N
Department of Cardiology, Siyami Ersek Cardiovascular Research and Training Hospital, Inonu Cad Sumko Sit K2 blok Daire 11, Kozyatagi, Istanbul, Turkey. sayarnurten@gmail.com
Lütfullah Orhan
A
A
Cakmak
Nazmiye
N
Yilmaz
Hale
H
Atmaca
Hüsnü
H
Tangürek
Burak
B
Hasdemir
Hakan
H
Nurkalem
Zekeriya
Z
Ergelen
Mehmet
M
Aksu
Hale
H
Yeşilçimen
Kemal
K
D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D002908:Chronic Disease; D015897:Comorbidity; D003971:Diastole; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000097:blood* / Q000000981:diagnostic imaging / Q000503:physiopathology*; D009200:Myocardial Contraction / Q000502:physiology; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D018709:Statistics, Nonparametric; D013599:Systole
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain