Prognostic value of ventricular-arterial coupling and B-type natriuretic peptide in patients after myocardial infarction: a five-year follow-up study.
BACKGROUND
The aim of this study was to determine the prognostic role of ventricular-arterial coupling compared with B-type natriuretic peptide (BNP) in patients after myocardial infarctions.


METHODS
Forty-one consecutive patients with history of myocardial infarctions were enrolled. Ventricular-arterial coupling was assessed as the ratio between arterial elastance (E(a)) and end-systolic ventricular elastance (E(es)). E(a) and E(es) were calculated using systolic and diastolic blood pressure, echocardiographically derived stroke volume, left ventricular ejection fraction, and the ratio between aortic preejection time and total systolic time. Cardiovascular mortality was the prespecified endpoint, with 5-year follow-up.


RESULTS
BNP was significantly correlated with New York Heart Association class and known echocardiographic parameters of systolic and diastolic left ventricular function and also with the E(a)/E(es) ratio (P = .001), which emerged as an independent correlate of BNP in multivariate analysis. The E(a)/E(es) ratio demonstrated good accuracy in predicting long-term cardiovascular mortality (area under the receiver operating characteristic curve, 0.73; P = .019), comparable with that of BNP in patients after myocardial infarctions.


CONCLUSIONS
Ventricular-arterial coupling assessed using the E(a)/E(es) ratio is an independent echocardiographic correlate of BNP levels in patients with previous myocardial infarctions and has a significant role in predicting long-term cardiovascular mortality in this setting.
Cardiologia, ARC, Azienda Ospedaliera S Maria Degli Angeli, Pordenone, Italy. cardiologia@aopn.fvg.it
Francesco
F
Antonini-Canterin
Roxana
R
Enache
Bogdan Alexandru
BA
Popescu
Andreea Catarina
AC
Popescu
Carmen
C
Ginghina
Elisa
E
Leiballi
Rita
R
Piazza
Daniela
D
Pavan
Daniela
D
Rubin
Piero
P
Cappelletti
Gian Luigi
GL
Nicolosi
D000368:Aged; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D016022:Case-Control Studies; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D004452:Echocardiography; D004548:Elasticity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008297:Male; D009203:Myocardial Infarction / Q000097:blood* / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011379:Prognosis; D012372:ROC Curve; D018709:Statistics, Nonparametric; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*; D017725:Ventricular Pressure
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain