The correlation of left atrial volume index to the level of N-terminal pro-BNP in heart failure with a preserved ejection fraction.
BACKGROUND
Patients with heart failure with a preserved ejection fraction (HFPEF) have high N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) level and a high ratio of early transmitral inflow to diastolic velocity of the mitral annulus (E/E') derived from tissue Doppler imaging (TDI). Because left atrial volume indexed to body surface area (LAVI) is believed to reflect chronic diastolic dysfunction, we assessed the ability of LAVI and E/E' ratio to predict NT-pro-BNP level in patients with HFPEF.


METHODS
One hundred forty-eight patients with HFPEF (ejection fraction >or= 50%, NT-pro-BNP >or= 100 pg/ml) underwent conventional echocardiography including LAVI and E/E' ratio, which were compared with NT-pro-BNP level.


RESULTS
In the overall patient population, modest correlations were found between NT-pro-BNP level and peak systolic TDI (S') (P = 0.009), LAVI (P = 0.009), and E/E' ratio (P = 0.017). However, in patients with E/E' ratio >or=13, LAVI was the most important predictor of NT-pro-BNP level (P < 0.001), whereas in those with E/E' ratio <13 it was S' (P < 0.001) in multivariate analysis.


CONCLUSIONS
In patients with HFPEF evidenced by high NT-pro-BNP level, LAVI correlates with NT-pro-BNP level in the setting of elevated E/E' ratio. However, in the setting of low E/E' ratio, LAVI does not seem to be associated with NT-pro-BNP level.
Kim
Hyungseop
H
Division of Cardiology, Department of Internal Medicine, Dongsan Medical Center, Keimyung University, Jung-gu, Daegu, Republic of Korea. khyungseop@dsmc.or.kr
Jun
Dong-Whan
DW
Cho
Yun-Kyeong
YK
Nam
Chang-Wook
CW
Han
Seong-Wook
SW
Hur
Seung-Ho
SH
Kim
Yoon-Nyun
YN
Kim
Kwon-Bae
KB
D000368:Aged; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006333:Heart Failure / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009929:Organ Size; D010446:Peptide Fragments / Q000097:blood*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D013318:Stroke Volume; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000000981:diagnostic imaging*
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain