title: Myocardial tissue Doppler echocardiography and N-terminal B-type natriuretic peptide (NT-proBNP) in diastolic and systolic heart failure.
abstract: BACKGROUND
  The aim of this prospective study was to assess the diagnostic value of NT-proBNP and the concordance with Tissue Doppler Echocardiography (including strain and longitudinal displacement) in diastolic and systolic heart failure.
  
  
  RESULTS
  137 consecutive clinically stable patients were included (42 healthy controls, 43 with diastolic heart failure, 52 with systolic heart failure). In diastolic heart failure, basal septal strain was reduced (-24.8 +/- 8.1% vs. controls. -18.5 +/- 5.3%, p < 0.0001). In all patients with preserved systolic function, septal basal longitudinal displacement was impaired in patients with increased left-ventricular filling pressures (E/E' < 8: 13.5 mm +/- 3.3 mm vs. E/E' > 15: 8.5 mm +/- 2.3 mm, p = 0.001) parallel to NT-proBNP elevation (E/E' < 8: 45.8 pg/ml, IQR: 172.5 pg/ml vs. E/E' > 15: 402.0 pg/ml, IQR: 1337.2 pg/ml; p = 0.0007). In ROC analysis, NT-proBNP could detect patients with reduced left ventricular systolic function (LVEF >or= 55%) with a good diagnostic accuracy. However, the diagnostic accuracy of NT-proBNP to detect diastolic dysfunction was lower.
  
  
  CONCLUSIONS
  Subtle changes of longitudinal myocardial function begin in diastolic heart failure and are further increased in systolic heart failure. In patients with preserved LV function, a complex approach with the integration of multiple parameters including Tissue Doppler echocardiography and NT-proBNP is necessary to classify patients.
authors.affiliation: Universitätsmedizin Berlin, Medical Clinic for Cardiology and Angiology, Charité Campus Mitte, Charitéplatz 1, Berlin, Germany. fabian.knebel@charite.de
authors.forename: Fabian
authors.initials: F
authors.lastname: Knebel
authors.forename: Stephan
authors.initials: S
authors.lastname: Eddicks
authors.forename: Ingolf
authors.initials: I
authors.lastname: Schimke
authors.forename: Michael
authors.initials: M
authors.lastname: Bierbaum
authors.forename: Sebastian
authors.initials: S
authors.lastname: Schattke
authors.forename: Mark
authors.initials: M
authors.lastname: Beling
authors.forename: Vanessa
authors.initials: V
authors.lastname: Raab
authors.forename: Gert
authors.initials: G
authors.lastname: Baumann
authors.forename: Adrian C
authors.initials: AC
authors.lastname: Borges
mesh_terms: D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D015150:Echocardiography, Doppler; D005260:Female; D006321:Heart / Q000503:physiopathology; D054144:Heart Failure, Diastolic / Q000097:blood* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D054143:Heart Failure, Systolic / Q000097:blood* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011446:Prospective Studies; D012372:ROC Curve; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
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