title: Longitudinal changes of left ventricular filling pressure and N-terminal pro-brain natriuretic peptide on chronic hemodialysis.
abstract: BACKGROUND
  Left ventricular filling pressure (LVFP) is related to the long-term prognosis in end-stage renal disease. The aims of this study were to evaluate the time course of the changes in LVFP, the predictors for the changes of LVFP, and the plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) levels as indicators for the changes of LVFP in chronic hemodialysis (HD).
  
  
  METHODS
  This study was designed prospectively. Doppler echocardiographic examinations and measurement of plasma NT-proBNP levels were performed in 37 consecutive patients on chronic HD and repeated at median of 43 months later. A ratio of peak early transmitral flow velocity to peak early diastolic mitral annular velocity (E/Em), an estimate of LVFP, was calculated.
  
  
  RESULTS
  E/Em ratios were significantly increased during the follow-up period. In multivariate analysis, age and changes of LVMI were independently associated with the changes of E/Em ratios. The plasma NT-proBNP levels were independently associated with E/Em at baseline and at the end of follow-up. The changes of plasma NT-proBNP levels were independently associated with changes of E/Em ratios (b-coefficient 0.453, p = 0.003).
  
  
  CONCLUSIONS
  Our data suggest that the deterioration of LVFP parallels with the progression of LV hypertrophy. Monitoring the plasma NT-proBNP levels might be useful for the detection of the LVFP changes in chronic HD.
authors.affiliation: Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Y K
authors.initials: YK
authors.lastname: Kim
authors.forename: S J
authors.initials: SJ
authors.lastname: Shin
authors.forename: S-H
authors.initials: SH
authors.lastname: Ihm
authors.forename: C S
authors.initials: CS
authors.lastname: Park
authors.forename: H-Y
authors.initials: HY
authors.lastname: Kim
authors.forename: T Y
authors.initials: TY
authors.lastname: Hong
authors.forename: H C
authors.initials: HC
authors.lastname: Song
authors.forename: C W
authors.initials: CW
authors.lastname: Yang
authors.forename: Y-S
authors.initials: YS
authors.lastname: Kim
authors.forename: E J
authors.initials: EJ
authors.lastname: Choi
mesh_terms: D018660:Blood Pressure Monitoring, Ambulatory; D018450:Disease Progression; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000378:metabolism*; D010446:Peptide Fragments / Q000378:metabolism*; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D006435:Renal Dialysis; D018709:Statistics, Nonparametric; D017725:Ventricular Pressure / Q000502:physiology*
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain