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. 2008 Dec;156(6):1191-5.
doi: 10.1016/j.ahj.2008.07.022. Epub 2008 Oct 15.

Independent prognostic value of echocardiography and N-terminal pro-B-type natriuretic peptide in patients with heart failure

Alan L Hinderliter  1 , James A Blumenthal, Christopher O'Conner, Kirkwood F Adams, Carla Sueta Dupree, Robert A Waugh, Daniel Bensimhon, Robert H Christenson, Andrew Sherwood
Affiliations

Independent prognostic value of echocardiography and N-terminal pro-B-type natriuretic peptide in patients with heart failure

Alan L Hinderliter et al. Am Heart J. 2008 Dec.

Abstract

Background: Echocardiographic indices of cardiac structure and function and natriuretic peptide levels are strong predictors of mortality in patients with heart failure. Whether cardiac ultrasound and natriuretic peptides provide independent prognostic information is uncertain.

Methods: Echocardiograms and measurements of N-terminal pro-brain natriuretic peptide (NT-proBNP) were prospectively performed in 211 patients with left ventricular systolic dysfunction who were followed for a median of 4 years. Echocardiographic variables and NT-proBNP were examined as predictors of all-cause mortality in univariable and multivariable proportional hazards models.

Results: Participants averaged 57 years old (SD 12 years) and had a mean left ventricular ejection fraction of 32% (SD 11%). A total of 71 patients (34%) died during the follow-up period. N-terminal pro-brain natriuretic peptide was a strong predictor of mortality (P < .001) as were multiple echocardiographic measures. In models that included age and NT-proBNP, with other clinical variables eligible for entry by stepwise selection, significant predictors of death included left ventricular ejection fraction (P = .013) and end-diastolic volume (P < .001), left atrial volume index (P = .005), right atrial volume index (P = .003), and tricuspid regurgitation area (P = .015). In models that also included left ventricular ejection fraction, end-diastolic volume of the left ventricle (P = .019), left atrial volume (P = .026), and right atrial volume (P = .020) remained significant predictors of mortality.

Conclusions: Left ventricular size and function and left atrial and right atrial sizes are significant predictors of all-cause mortality in patients with heart failure, independent of NT-proBNP levels and other clinical variables.

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References

    1. Grayburn PA, Appleton CP, DeMaria AN, et al. Echocardiographic predictors of morbidity and mortality in patients with advanced heart failure. J Am Coll Cardiol. 2005;45:1064–1071. - PubMed
    1. St John Sutton M, Pfeffer MA, Moye L, et al. Cardiovascular death and left ventricular remodeling two years after myocardial infarction: baseline predictors and impact of long-term use of captopril: information from the Survival and Ventricular Enlargement (SAVE) trial. Circulation. 1997;96:3294–3299. - PubMed
    1. Rihal CS, Nishimura RA, Hatle LK, et al. Systolic and diastolic dysfunction in patients with clinical diagnosis of dilated cardiomyopathy. Relation to symptoms and prognosis. Circulation. 1994;90:2772–2779. - PubMed
    1. Parameshwar J, Keegan J, Sparrow J, et al. Predictors of prognosis in severe chronic heart failure. Am Heart J. 1992;123:421–426. - PubMed
    1. Rossi A, Cicoira M, Zanolla L, et al. Determinants and prognostic value of left atrial volume in patients with dilated cardiomyopathy. J Am Coll Cardiol. 2002;40:1425–1430. - PubMed

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