Changes in Tissue-Doppler Echocardiographic Assessment of Left Ventricular Filling During NT-proBNP Guided Heart Failure Treatment Titration: A Pilot Study - 13/08/11
, Gillian A. Whalley, PhD b, Helen A. Walsh, BSc b, Greg D. Gamble, MSc b, Robert N. Doughty, MD b
Corresponding author. Tel.: +64 9 307 4949; fax: +64 9 307 4950.Résumé |
Background |
Although brain natriuretic peptide (BNP) and E/Ea are closely related in heart failure (HF) patients and may be helpful to guide HF therapy, the response of E/Ea to changes in BNP over several weeks of intensive HF treatment optimisation is unknown. This study was designed to investigate this relationship.
Methods and results |
In 17 patients with decompensated HF, treatment was titrated to reduce the NT-proBNP level to <200pg/mL over 10 weeks. Paired NT-proBNP measurements and echocardiograms were performed at two weekly intervals during the study. Treatment titration was associated with a reduction in E/Ea (17.6±6.8S.D. to 13.7±5.0S.D., p=0.018) in keeping with the reduction in NT-proBNP (median 603 [S.E. 561] to 311 [S.E. 235], p=0.045). This relationship remained in those who responded to titration (reduction in NT-proBNP of ≥50%), and those who did not. The overall change in E/Ea was similar to the changes observed in NT-proBNP in each group however there appeared to be temporal differences in the changes in E/Ea and NT-proBNP.
Conclusion |
This pilot study demonstrates that the E/Ea decreases after NT-proBNP guided HF therapy. E/Ea may be a complementary target for HF therapy optimisation; this hypothesis should be further evaluated in larger scale randomised trials.
Le texte complet de cet article est disponible en PDF.Keywords : Heart failure, Natriuretic peptides, Tissue Doppler, Echocardiography, Treatment
Plan
Vol 18 - N° 1
P. 38-44 - février 2009 Retour au numéro
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