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European Journal of Echocardiography 2006 7(1):45-52; doi:10.1016/j.euje.2005.04.014
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Copyright © 2005, The European Society of Cardiology

Left ventricular cavity area reflects N-terminal pro-brain natriuretic peptide plasma levels in heart failure*

Raquel Taléns-Viscontia, Miguel Rivera Oteroa,*, Ma José Sancho-Tellob, Fernando García de Burgosc, Luis Martínez-Dolzb, Begoña Sevillad, Vicente Climente, Raquel Cortésa, Antonio Salvadord, Francisco Sogorbe, Vicente Mirob, Ricardo Valerof, Jose Luis Perez-Boscág, Vicente Bertomeuf, Manuel Portolésa and Rafael Payág

aResearch Center La Fe Hospital, Valencia, Spain
bLa Fe Hospital, Valencia, Spain
cElche Hospital, Elche, Spain
dDr. Peset Hospital, Valencia, Spain
eGeneral Hospital, Alicante, Spain
fSan Juan Hospital, Alicante, Spain
gGeneral Hospital, Valencia, Spain

Received 22 November 2004; received in revised form 14 April 2005; accepted after revision 20 April 2005.

* Corresponding author. José María Haro, 59, puerta 59, 46022 Valencia, Spain. Tel.: +34 96 371 61 98; fax: +34 96 1973018. rivera_jmi{at}gva.es


   Abstract

Aims N-terminal pro-brain natriuretic peptide (NT-proBNP) is useful in the diagnosis of heart failure (HF). LV two-dimensional cavity area from end-diastole (LVEDA) and end-systole (LVESA), and LV fractional area change (LVFAC) reflect changes in LV morphology and function without using geometric assumptions. In a multicenter study, we correlated LVEDA, LVESA and LVFAC with NT-proBNP, comparing patients with dilated and ischemic cardiomyopathy.

Methods and results We studied 106 HF patients. In the dilated group, NT-proBNP correlated with LVEDAI (r=0.6), LVESAI (r=0.7) and LVFAC (r=–0.6), all significant at p<0.001. In patients with ischemic cardiomyopathy we found LVESAI (r=0.3, p<0.05) and LVFAC (r=–0.4, p<0.01). After adjustment for age and BMI, LVFAC and LVESAI were associated in a multiple linear regression analysis with peptide levels (adjusted r2=0.5, p<0.001).

Conclusions In this study we found a good correlation of NT-proBNP with LV cavity areas and LVFAC. Multiple regression analysis showed that when adjusted for age and BMI, LVFAC and LVESAI are independent predictors of NT-proBNP levels in both dilated and ischemic etiologies. Patients with dilated cardiomyopathy showed better results than those with ischemic cardiomyopathy. We think LV areas are a useful and reproducible parameter, do not need geometric assumptions and reflect NT-proBNP plasma levels.

Keywords: Heart failure; NT-proBNP; Left ventricular two-dimensional cavity area


* The research support source was from the National Institute of Health Fondo de Investigaciones Sanitarias del Instituto de Salud Carlos III, FIS 01/0943 Project, Spain.


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