title: Relation between E/e' ratio and NT-proBNP levels in elderly patients with symptomatic severe aortic stenosis.
abstract: BACKGROUND
  Symptoms in the elderly patients with severe aortic stenosis (AS) and co-morbidities seem to lack in specificity. Therefore, objective parameters for increased left ventricular(LV) filling pressures are needed. The aim of this study was to investigate the correlation between the septal, lateral and average E/e' ratio and the value of the N-terminal pro-hormone of brain natriuretic peptide (NT-proBNP).
  
  
  METHODS
  Two-hundred-fifty consecutive symptomatic patients (mean age 80 ± 8 years, 52% men) with severe AS underwent transthoracic echocardiography and NT-proBNP measurement.
  
  
  RESULTS
  In the overall population the septal E/e' (r = 0,459, r(2) = 0,21, P <0,0001), lateral E/e' (r = 0,322, r(2) = 0,10, P <0,0001), and the average E/e' (r = 0,432, r(2) = 0,18, P <0,0001) were all significantly correlated to NT-proBNP. After the exclusion of patients with confounders (more than mild aortic or mitral regurgitation, severe renal dysfunction, obesity or severe COPD) the septal E/e' (r = 0,584, r(2) = 0,34, P <0,0001), lateral E/e' (r = 0,377, r(2) = 0,14, P <0,0001), and the average E/e' (r = 0,487, r(2) = 0,24, P <0,0001) were all significantly better correlated to NT-proBNP. In obese patients no significant correlations were seen. Previous bypass surgery did not alter the correlations.
  
  
  CONCLUSIONS
  In elderly patients with severe symptomatic AS there is a significant correlation between the E/e' ratio and NT-proBNP, in particular after exclusion of confounders. The correlation was best for the septal E/e' ratio and was preserved in patients with a history of bypass surgery.
authors.affiliation: Department of Cardiology, Thorax Center, Erasmus MC Rotterdam, PB 412, 3000, CA, Rotterdam, The Netherlands. m.strachinaru@erasmusmc.nl.
authors.forename: Mihai
authors.initials: M
authors.lastname: Strachinaru
authors.affiliation: Department of Cardiology, Thorax Center, Erasmus MC Rotterdam, PB 412, 3000, CA, Rotterdam, The Netherlands.
authors.forename: Bas M
authors.initials: BM
authors.lastname: van Dalen
authors.affiliation: Department of Cardiology, Thorax Center, Erasmus MC Rotterdam, PB 412, 3000, CA, Rotterdam, The Netherlands.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Van Mieghem
authors.affiliation: Department of Cardiology, Thorax Center, Erasmus MC Rotterdam, PB 412, 3000, CA, Rotterdam, The Netherlands.
authors.forename: Peter P T
authors.initials: PP
authors.lastname: De Jaegere
authors.affiliation: Department of Cardiology, Thorax Center, Erasmus MC Rotterdam, PB 412, 3000, CA, Rotterdam, The Netherlands.
authors.forename: Tjebbe W
authors.initials: TW
authors.lastname: Galema
authors.affiliation: Cardiology, Brugmann University Hospital Brussels, Brussels, Belgium.
authors.forename: Marielle
authors.initials: M
authors.lastname: Morissens
authors.affiliation: Department of Cardiology, Thorax Center, Erasmus MC Rotterdam, PB 412, 3000, CA, Rotterdam, The Netherlands.
authors.forename: Marcel L
authors.initials: ML
authors.lastname: Geleijnse
mesh_terms: D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging*; D015415:Biomarkers / Q000097:blood; D004452:Echocardiography / Q000379:methods; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000000981:diagnostic imaging* / Q000209:etiology
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain