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. 2015 Jul-Aug;67(4):318-27.
doi: 10.1016/j.ihj.2015.04.023. Epub 2015 May 20.

Prognostic significance of NT-proBNP, 3D LA volume and LV dyssynchrony in patients with acute STEMI undergoing primary percutaneous intervention

C Siva Sankara  1 , D Rajasekhar  2 , V Vanajakshamma  3 , B S Praveen Kumar  4 , A Vamsidhar  1
Affiliations

Prognostic significance of NT-proBNP, 3D LA volume and LV dyssynchrony in patients with acute STEMI undergoing primary percutaneous intervention

C Siva Sankara et al. Indian Heart J. 2015 Jul-Aug.

Abstract

Objectives: The aim of the present study was to assess the short term prognostic significance of N-terminal pro BNP (NT-proBNP), 3D left atrial volume (LAV) and left ventricular (LV) dyssynchrony in patients of acute ST-elevation myocardial infarction (STEMI) who underwent primary Percutaneous intervention (PCI).

Background: NT-proBNP, LV dyssynchrony and LAV in patients with acute coronary syndrome have been associated with PCI outcomes and predict the short and long-term prognosis.

Methods: This study consisted of 142 patients with a first STEMI who underwent primary PCI. Baseline echocardiographic data was collected at admission and at 6 months follow up. Left ventricular dyssynchrony was measured by tissue Doppler imaging and LAV by real time 3D-echocardiography, plasma NT-proBNP levels were estimated between 72 and 96 h of admission.

Results: During study period 3 patients expired and 4 developed congestive heart failure (CHF). Baseline NT-proBNP and LV dyssynchrony correlated with LV size and LV ejection fraction (LVEF) at baseline and during follow up. Patients with higher NT-proBNP levels and higher LV dyssynchrony showed significant increase in LV size with decrease in LVEF during follow-up. Baseline Left atrial volume index (LAVI) showed significant correlation with LV size but no association with LVEF at baseline and during follow-up.

Conclusions: Higher levels of NT-proBNP and higher LV dyssynchrony can predict patients with increase in LV size, worsening of LV systolic and diastolic function during follow-up. Patients with higher NT-proBNP levels at baseline developed CHF during follow-up.

Keywords: Left atrial volume; Left ventricular dyssynchrony; NT-proBNP; Primary percutaneous intervention; ST-Elevation myocardial infarction.

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Figures

Fig. 1
Fig. 1
Image showing LA volume by RT3DE in a study patient.
Fig. 2
Fig. 2
Image showing assessment of LV dyssynchrony by TDI.
Fig. 3
Fig. 3
Comparison of NT-proBNP, LA volume and LV dyssynchrony in patients with increase in LVEDD and no change in LVEDD.
See this image and copyright information in PMC

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