title: Prognostic significance of NT-proBNP, 3D LA volume and LV dyssynchrony in patients with acute STEMI undergoing primary percutaneous intervention.
abstract: OBJECTIVE
  The aim of the present study was to assess the short term prognostic significance of N-terminal pro BNP (NT-proBNP), 3D left atrial volume (LAV) and left ventricular (LV) dyssynchrony in patients of acute ST-elevation myocardial infarction (STEMI) who underwent primary Percutaneous intervention (PCI).
  
  
  BACKGROUND
  NT-proBNP, LV dyssynchrony and LAV in patients with acute coronary syndrome have been associated with PCI outcomes and predict the short and long-term prognosis.
  
  
  METHODS
  This study consisted of 142 patients with a first STEMI who underwent primary PCI. Baseline echocardiographic data was collected at admission and at 6 months follow up. Left ventricular dyssynchrony was measured by tissue Doppler imaging and LAV by real time 3D-echocardiography, plasma NT-proBNP levels were estimated between 72 and 96 h of admission.
  
  
  RESULTS
  During study period 3 patients expired and 4 developed congestive heart failure (CHF). Baseline NT-proBNP and LV dyssynchrony correlated with LV size and LV ejection fraction (LVEF) at baseline and during follow up. Patients with higher NT-proBNP levels and higher LV dyssynchrony showed significant increase in LV size with decrease in LVEF during follow-up. Baseline Left atrial volume index (LAVI) showed significant correlation with LV size but no association with LVEF at baseline and during follow-up.
  
  
  CONCLUSIONS
  Higher levels of NT-proBNP and higher LV dyssynchrony can predict patients with increase in LV size, worsening of LV systolic and diastolic function during follow-up. Patients with higher NT-proBNP levels at baseline developed CHF during follow-up.
authors: Senior Resident, Department of Cardiology, SVIMS, Tirupati, Andhra Pradesh, India.
authors: C
authors: C
authors: Siva Sankara
authors: Professor & Head, Department of Cardiology, SVIMS, Tirupati, Andhra Pradesh, India. Electronic address: cardiologysvims@gmail.com.
authors: D
authors: D
authors: Rajasekhar
authors: Professor, Department of Cardiology, SVIMS, Tirupati, Andhra Pradesh, India.
authors: V
authors: V
authors: Vanajakshamma
authors: Assistant Professor, Department of Cardiology, SVIMS, Tirupati, Andhra Pradesh, India.
authors: B S
authors: BS
authors: Praveen Kumar
authors: Senior Resident, Department of Cardiology, SVIMS, Tirupati, Andhra Pradesh, India.
authors: A
authors: A
authors: Vamsidhar
mesh_terms: D015415:Biomarkers / Q000097:blood; D002306:Cardiac Volume / Q000502:physiology*; D018450:Disease Progression; D015150:Echocardiography, Doppler; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D012189:Retrospective Studies; D000072657:ST Elevation Myocardial Infarction / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000209:etiology / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology; D020257:Ventricular Remodeling
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Left atrial volume; Left ventricular dyssynchrony; NT-proBNP; Primary percutaneous intervention; ST-Elevation myocardial infarction