title: Usefulness of plasma brain natriuretic peptide measurement and tissue Doppler imaging in identifying isolated left ventricular diastolic dysfunction without heart failure.
abstract: Left ventricular (LV) diastolic dysfunction carries a substantial risk for the subsequent development of heart failure and reduced survival, even when it is asymptomatic. Plasma brain natriuretic peptide (BNP) level and tissue Doppler imaging indexes provide powerful incremental assessment of LV diastolic function. Accordingly, the aim of this study was to clarify whether these methodologies could identify LV diastolic dysfunction without heart failure in 280 patients with preserved LV ejection fractions (> or =50%) who underwent echocardiography and cardiac catheterization for the evaluation of coronary artery disease. Patients were classified into 2 groups, those with diastolic dysfunction (tau > or =48 ms; n = 91) and those with normal diastolic function (tau <48 ms; n = 189). Plasma BNP > or =22.4 pg/ml, an unexpectedly low value, had sensitivity of 74.7% and specificity of 60.8% for identifying isolated LV diastolic dysfunction; the combined use of BNP > or =22.4 pg/mL and mitral annular velocity during early diastole <7.4 cm/s had relatively low sensitivity of 44.0% but high specificity of 86.8%. In conclusion, using plasma BNP level and with the combination of BNP level and mitral annular velocity during early diastole, invasively proved isolated LV diastolic dysfunction without heart failure could be identified in patients with coronary artery disease.
authors.affiliation: Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Goto
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ohte
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Wakami
authors.forename: Kaoru
authors.initials: K
authors.lastname: Asada
authors.forename: Hidekatsu
authors.initials: H
authors.lastname: Fukuta
authors.forename: Seiji
authors.initials: S
authors.lastname: Mukai
authors.forename: Tomomitsu
authors.initials: T
authors.lastname: Tani
authors.forename: Genjiro
authors.initials: G
authors.lastname: Kimura
mesh_terms: D000368:Aged; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000000981:diagnostic imaging*
chemical_list: D020097:Natriuretic Peptide, Brain