Risk stratification in chronic heart failure: Independent and incremental prognostic value of echocardiography and brain natriuretic peptide and its N-terminal fragment

被引:30
|
作者
Bruch, C
Rothenburger, M
Gotzmann, M
Sindermann, J
Scheld, HH
Breithardt, G
Wichter, T
机构
[1] Hosp Univ Munster, Dept Cardiol, Munster, Germany
[2] Hosp Univ Munster, Dept Angiol, Munster, Germany
[3] Hosp Univ Munster, Dept Thorac & Cardiovasc Surg, Munster, Germany
关键词
D O I
10.1016/j.echo.2005.12.027
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: It was the aim of this study to compare the prognostic impact of echocardiography and brain natriuretic peptide and its N-terminal fragment (NT-proBNP) in patients with chronic heart failure (CHF). Methods. In all, 73 patients with CHT underwent conventional 2-dimensional/Doppler echocardiography and Doppler tissue analysis of systolic, early and late diastolic mitral annular velocities. The mitral filling pattern was classified as restrictive or nonrestrictive. NT-proBNP measurements were carried out on a bench-top analyzer. A cardiac event (rehospitalization caused by worsening CHF, cardiac death, urgent cardiac transplantation) was defined as combined study end point. Results: During follow-up of 226 169 days, 27 patients had an event (rehospitalization because of CHF, n = 18; cardiac death, n = 7; urgent transplantation, n = 2). On multivariate Cox regression analysis, a restrictive filling pattern, NT-proBNP, the ratio of peak early diastolic mitral flow to mitral annular E' velocity were independent prognostic predictors. A risk stratification model based on the 3 strongest independent predictors separated groups into those with good, intermediate, and poor outcome (event-free survival of 78%, 46%, and 0%, respectively). Conclusions: In patients with CHF, Doppler echocardiography, Doppler tissue imaging, and NT-proBNP provide independent and incremental prognostic information. A combined use of echocardiography and NT-proBNP may help to improve risk stratification in this patient population.
引用
收藏
页码:522 / 528
页数:7
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