Prognostic implications of the NT-ProBNP level and left atrial size in non-ischemic dilated cardiomyopathy.
BACKGROUND
The ratio of peak early diastolic mitral inflow to annular velocity (E/E') and left atrial size could provide prognosis on congestive heart failure (CHF). N-terminal Pro B-type natriuretic peptide (NT-ProBNP) has also been useful for predicting adverse cardiac events. However, it is not clear how these parameters compare with conventional risk factors. Thus, we investigated whether E/E', left atrial dimension index (LADI) and NT-ProBNP would predict adverse events and add incremental value to conventional risk factors, even in non-ischemic advanced dilated cardiomyopathy (DCM).


RESULTS
Both NT-ProBNP and echocardiography were evaluated in 105 patients. The cardiac events were defined as the composite of cardiac death and re-admission for CHF. At follow up, cardiac events occurred in 24 patients who had high NT-ProBNP and showed higher LADI and E/E'. In multivariate analysis, both NT-ProBNP and LADI, but not E/E', remained as independent predictors; patients with both increased LADI and NT-ProBNP had a 27-fold higher risk of cardiac events than those without any risk factors (p = 0.003). Moreover, LADI and NT-ProBNP showed a better incremental prognostic value over conventional risk factors (global chi-square increase from 7 to 17 to 49, p = 0.003, p < 0.001, respectively).


CONCLUSIONS
Both NT-ProBNP and LADI might have the most predictable power, particularly in non-ischemic advanced DCM.
Kim
Hyungseop
H
Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea. khyungseop@dsmc.or.kr
Cho
Yun-Kyeong
YK
Jun
Dong-Hwan
DH
Nam
Chang-Wook
CW
Han
Seong-Wook
SW
Hur
Seung-Ho
SH
Kim
Yoon-Nyun
YN
Kim
Kwon-Bae
KB
D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D002311:Cardiomyopathy, Dilated / Q000097:blood* / Q000000981:diagnostic imaging / Q000473:pathology*; D003971:Diastole / Q000502:physiology; D004562:Electrocardiography; D005260:Female; D005919:Glomerular Filtration Rate; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D013599:Systole / Q000502:physiology; D014463:Ultrasonography
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein