title: [Myocardial and Arterial Stiffness Important Determinant of NT-ProBNP at Development of Heart Failure in Survivors of Myocardial Infarction].
abstract: OBJECTIVE
  To study diagnostic value of myocardial-arterial stiffness (MAS) as a determinant of N-terminal pro-brain natriuretic peptide (NT-proBNP) expression in patients with chronic heart failure (CHF) with ischemic or postinfarction left ventricular (LV) dysfunction.
  
  
  METHODS
  We analyzed 6 months prognosis of 54 patients (mean age 61.7+/-8.6 years) with II-III NYHA class CHF divided into 2 groups: (I, n=18) with class II CHF and preserved LV ejection fraction (EF) (55+/-10.4%), (II, n=36) with class III CHF and low LF EF (30.4+/-6.8%). MAS was measured by echocardiography as ratio of arterial elasticity (Ea) and end-systolic elasticity of LV myocardium (Es). Serum NT-proBNP was measured by immunoenzyme assay.
  
  
  RESULTS
  During 6 months follow-up one group II patient with initial NT-proBNP level 2020 rg/ml died. NT-proBNP level in group I was significantly lower than in group II (313 and 647 rg/ml, respectively). Ea/Es ratio was significantly higher (p=0.001) in group II. Multifactorial analysis demonstrated moderate correlation of NT-proBNP with Ea/Es ratio (r=0.50, p=0.0001) and negative correlation with LVEF (r=-0.45, =0.003) among patients with II-III class CHF.
  
  
  CONCLUSIONS
  As correlation between symptoms and severity of clinical manifestations of ischemic or postinfarction cardiac dysfunction at development of CHF was not high it appears rational to consider MAS estimated by Ea/Es ratio as independent predictor of cardiovascular complications. Sufficiently close correlation between NT-proBNP and Ea/Es ratio allows to improve stratification of risk and to assess objectively prognosis of the disease using easier obtainable parameter Ea/Es in cases when possibility to measure NT-proBNP is not available.
authors.affiliation: Research Institute for Cardiology, Tomsk, Russia.
authors.forename: A T
authors.initials: AT
authors.lastname: Teplyakov
authors.affiliation: Research Institute for Cardiology, Tomsk, Russia.
authors.forename: E Yu
authors.initials: EY
authors.lastname: Pyshnikova
authors.affiliation: Research Institute for Cardiology, Tomsk, Russia.
authors.forename: A V
authors.initials: AV
authors.lastname: Andriyanova
authors.affiliation: Research Institute for Cardiology, Tomsk, Russia.
authors.forename: V V
authors.initials: VV
authors.lastname: Kalyuzhin
authors.affiliation: Research Institute for Cardiology, Tomsk, Russia.
authors.forename: T E
authors.initials: TE
authors.lastname: Suslova
authors.affiliation: Research Institute for Cardiology, Tomsk, Russia.
authors.forename: E N
authors.initials: EN
authors.lastname: Nikonova
authors.affiliation: Research Institute for Cardiology, Tomsk, Russia.
authors.forename: R S
authors.initials: RS
authors.lastname: Karpov
mesh_terms: D000368:Aged; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000378:metabolism; D020097:Natriuretic Peptide, Brain; D010446:Peptide Fragments; D011379:Prognosis; D059289:Vascular Stiffness
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain