title: The relationship between tissue Doppler imaging and seric NTproBNP levels in sinus rhythm patients: a prospective study.
abstract: N-terminal pro-brain natriuretic peptide (NTproBNP) correlates with left ventricular (LV) filling pressure. The ratio between early diastolic transmitral velocity and early mitral annular diastolic velocity (E/Ea) reflects LV filling pressure in a variety of cardiac diseases. However this relationship was not validated in some categories of patients. Our aim was to evaluate the correlation between tissue Doppler velocities of the mitral annulus and NTproBNP levels in sinus rhythm patients.
  
  
  METHODS
  Echocardiography was performed in 111 consecutive patients simultaneously with NTproBNP measurement. E/Ea and E/(Ea x Sa) were calculated (Sa is the maximal systolic velocity of mitral annulus); the average of the velocities of septal and lateral mitral annulus was used.
  
  
  RESULTS
  Simple regression analysis demonstrated a significant linear correlation between E/(Ea x Sa) and NTproBNP (r = 0.71, P < 0.0001), superior to E/Ea correlation (r = 0.58, P < 0.0001). Significant but weaker correlations were found between NTproBNP and Sa, pulmonary artery systolic pressure, Ea, mitral E/A (early/late diastolic transmitral velocity), E wave, mitral E deceleration time and LV ejection fraction (LVEF). The optimal E/(Ea x Sa) cut-off for prediction of NTproBNP levels > 900 pg/ml was 1.5 (sensitivity = 81%, specificity = 70%). Among analyzed parameters, E/(Ea x Sa) was best correlated with NTproBNP levels in patients with LVEF >or= 50% (r = 0.80, P < 0.0001), with depressed LVEF (<50%) (r = 0.66, P < 0.0001), with regional wall motion abnormalities (r = 0.75, P < 0.0001), and with E/Ea 8 to 15 (r = 0.58, P < 0.0001).
  
  
  CONCLUSIONS
  E/(Ea x Sa) strongly correlates with NTproBNP, regardless of LVEF, and can be a simple and accurate echocardiographic index in patients in sinus rhythm, particularly in those with regional wall motion abnormalities or intermediate E/Ea.
authors.affiliation: Cardiology Clinic, Institute of Cardiovascular Diseases, Str PP Carp nr 13A, Timisoara, Romania. mornoscristi@yahoo.com
authors.forename: Cristian
authors.initials: C
authors.lastname: Mornos
authors.forename: Adina
authors.initials: A
authors.lastname: Ionac
authors.forename: Dragos
authors.initials: D
authors.lastname: Cozma
authors.forename: Dan
authors.initials: D
authors.lastname: Rusinaru
authors.forename: Daniela
authors.initials: D
authors.lastname: Maximov
authors.forename: Lucian
authors.initials: L
authors.lastname: Petrescu
authors.forename: Alina
authors.initials: A
authors.lastname: Lupu
authors.forename: Stefan-Iosif
authors.initials: SI
authors.lastname: Dragulescu
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology*; D008955:Models, Cardiovascular; D009038:Motion; D009200:Myocardial Contraction; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D012107:Research Design; D012849:Sinoatrial Node / Q000503:physiopathology*; D013318:Stroke Volume; D013997:Time Factors; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain