title: Value of NT-ProBNP level and echocardiographic parameters in ST-segment elevation myocardial infarction treated by primary angioplasty: relationships between these variables and their usefulness as predictors of ventricular remodeling.
abstract: OBJECTIVE
  To assess the value of N-terminal fragment of brain natriuretic peptide (NT-proBNP) measurement and echocardiography for predicting ventricular remodeling after myocardial infarction and to investigate relationships between the NT-proBNP level and echocardiographic parameters at discharge and in the medium term.
  
  
  METHODS
  The study involved 159 patients with myocardial infarction treated by primary coronary angioplasty. The NT-proBNP level was measured on admission, at discharge and after 6 months. Echocardiography was performed at discharge and after 6 months.
  
  
  RESULTS
  Overall, 31 patients (19.5%) demonstrated remodeling. At discharge, the variables associated with remodeling were: mitral inflow E-wave-to-A-wave velocity ratio (E/A), systolic mitral annulus velocity (Sm), early diastolic mitral annulus velocity (Em), the mitral inflow E wave to early diastolic mitral annulus velocity ratio (E/ Em), left atrial volume (LAV), left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV), and discharge NT-proBNP level. Only E/Em was an independent predictor of ventricular remodeling (odds ratio [OR]=1.143; 95% confidence interval [CI], 1.039-1.258; P=.006). At discharge, correlations were observed between the NT-proBNP level and LVEDV, LVESV, ejection fraction (EF) and E/Em. At 6 months, correlations with ventricular volumes and EF were unchanged, the correlation with E/Em was better (r=0.47 vs. r=0.69), and a modest correlation with LAV developed (r=0.43; P=.001).
  
  
  CONCLUSIONS
  The E/Em ratio was the best echocardiographic predictor of left ventricular remodeling after myocardial infarction. The NT-proBNP level had no additional predictive value over echocardiography. Correlations between the NT-proBNP level and ventricular volumes and EF at discharge and 6 months were similar, while correlations with E/Em and LAV were better at 6 months.
authors.affiliation: Area del Corazón. Hospitales Universitarios Virgen del Rocío. Sevilla. España. josee.lopez.sspa@juntadeandalucia.es
authors.forename: José
authors.initials: J
authors.lastname: López Haldón
authors.forename: Mónica
authors.initials: M
authors.lastname: Fernández Quero
authors.forename: Fernando
authors.initials: F
authors.lastname: Mancha
authors.forename: José A
authors.initials: JA
authors.lastname: Urbano
authors.forename: Agustín
authors.initials: A
authors.lastname: Guisado
authors.forename: Manuel
authors.initials: M
authors.lastname: Villa
authors.forename: Juan I
authors.initials: JI
authors.lastname: Valle
authors.forename: María J
authors.initials: MJ
authors.lastname: Rodríguez Puras
authors.forename: Sara
authors.initials: S
authors.lastname: Ballesteros
authors.forename: Francisco
authors.initials: F
authors.lastname: López Pardo
authors.forename: Luis
authors.initials: L
authors.lastname: Díaz de la Llera
authors.forename: Angel
authors.initials: A
authors.lastname: Sánchez González
authors.forename: Angel
authors.initials: A
authors.lastname: Martínez Martínez
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D014463:Ultrasonography; D020257:Ventricular Remodeling
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain