title: Usefulness of the Echocardiographic Multi-Parameter Score (EMPS) in evaluating left ventricular global heart function.
abstract: In this study, we established a new index by combining several echocardiographic parameters to quantify heart failure. We selected 233 consecutive patients who underwent both echocardiographic and plasma B-type natriuretic peptide (BNP) tests within 24 hours after referral for suspected heart failure. The echocardiographic parameters included systolic function, diastolic function, left ventricular chamber remodeling, valvular lesions, systolic pulmonary arterial pressure, and regional wall-motion abnormality. Each factor was scored from 1 to 3 points according to its severity. The total point from these 6 factors is the echocardiographic multi-parameter score (EMPS).The EMPS for 37, 51, 77, and 38 patients from New York Heart Association (NYHA) functional classes I, II, III, and IV, respectively, were 1.24 ± 1.25, 2.98 ± 1.83, 5.96 ± 2.38, and 7.21 ± 1.99, which were significantly different from the mean score of our 30 normal patients (P <0.001). Sensitivity, specificity, and accuracy of an EMPS ≥2 for diagnosis of NYHA classes II to IV were 93%, 83%, and 89%, respectively. The area under the receiver operating characteristic curve was 0.94 (95% confidence interval, 0.92-0.98; P <0.001). There were significant correlations between logBNP and EMPS (r=0.81, P <0.001) or Tei index (r=0.48, P <0.001). In multilinear regression analysis, EMPS, early/late transmitral flow, and peak systolic velocity from tissue Doppler were entered into the model (P <0.001). The standardized regression coefficient (r=0.68) of EMPS was much higher than those of the other 2 factors, which suggests that EMPS is a powerful predictor of BNP levels.
authors.affiliation: Department of Cardiology, the First Affiliated Hospital of Soochow University, Suzhou 215006, People's Republic of China.
authors.forename: Bingyuan
authors.initials: B
authors.lastname: Zhou
authors.forename: Junhua
authors.initials: J
authors.lastname: Yang
authors.forename: Xiangjun
authors.initials: X
authors.lastname: Yang
authors.forename: Yongming
authors.initials: Y
authors.lastname: He
authors.forename: Caiming
authors.initials: C
authors.lastname: Zhao
authors.forename: Sudan
authors.initials: S
authors.lastname: Xu
authors.forename: Huifeng
authors.initials: H
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D002681:China; D015150:Echocardiography, Doppler; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D012044:Regression Analysis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling; D055815:Young Adult
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain