0528: The role of brain natriuretic peptide and cystatin C in the evaluation of left ventricular diastolic dysfunction: correlation with echocardio-graphic indexes after myocardial infarction - 12/02/16
Résumé |
Background |
The utility of Brain Natriuretic Peptide (BNP) and cystatin C for detecting left ventricular (LV) diastolic dysfunction after myocardial infarction (MI) in patients without heart failure symptoms still unclear. In this study, we investigated the relation between BNP, serum cystatin C levels and LV diastolic dysfunction after MI in patients without systolic dysfunction.
Methods |
We studied 127 patients without renal dysfunction after first acute coronary syndrome (ACS). LV diastolic function was assessed with conventional Doppler, by means of mitral inflow and with tissue Doppler echo-cardiography by means of mitral annulus. The ratio of early diastolic transmitral E wave velocities to tissue Doppler mitral annulus early diastolic E’ wave velocities (E/E’), was used to detect LV filling pressures. Patients were divided in three groups according to E/E’ ratios<10 (group I), E/E’ ratios “between” 10 and 15 (group II) and E/E’ ratios>15 (group III). Plasma concentrations of BNP and serum cystatin C were measured at admission.
Results |
The BNP and serum cystatin C levels were positively correlated significantly with E/E’ ratio (r=0.786, P<0.001 and r=0.458, p=0.02). Patients with elevated LV end diastolic pressure (LVEDP), defined as E/E’>15 had highest BNP (321±75pg/mL) and cystatin C (1.1±0.2mg/L) levels. E/E’ 10 to 15 group had a mean BNP level of 151±28pg/mL and a mean cystatin C value of 0.78±0.1mg/L, and those with E/E’<10 had a mean BNP value of 69±20pg/ mL. A BNP value of 89pg/mL had a sensitivity of 84% and a specificity of 69% for predicting E/E’>15.
Conclusion |
The assessment of the blood concentration of BNP and cystatin C is of potential value for identification of those patients after myocardial infarction to detect early cardiovascular changes, especially LV diastolic dys-function.
Le texte complet de cet article est disponible en PDF.Vol 8 - N° 1
P. 27 - janvier 2016 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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