Correlation of E/E’ on echocardiography and BNP levels in diastolic dysfunction patients visiting Mardan Medical Complex
Keywords:
E/E', BNP, correlation, diastolic heart function, Doppler echocardiography, Tissue Doppler imaging (TDI), E/E' ratio, B-natriuretic peptide (BNP), LV pressures, diastolic dysfunctionAbstract
Introduction: Assessment of diastolic heart function can be challenging due to various factors. Doppler echocardiography is useful but has limitations, pointing to the need for more accurate tests. Tissue Doppler imaging (TDI) is a promising ultrasound technique for diastolic prediction. The E/E' ratio is commonly used to determine LV filling pressures. B-natriuretic peptide (BNP) levels may also indicate diastolic dysfunction. Aims: To compare the BNP levels with E/E' ratios in this investigation to evaluate their effectiveness in predicting LV pressures. Methodology: This study compared BNP levels with E/E' in patients with diastolic dysfunction. Patients with reduced LV function were excluded, and all participants gave informed consent. The study found that BNP levels were a useful diagnostic tool and could be compared with E/E' using ROC curves. Results: The study included 100 patients with diastolic dysfunction and excluded those with reduced LV function. The patients had a mean age of 60.51, with 60% males and 40% females. The majority of patients were in NYHA class II (56%), followed by NYHA class III (28%) and NYHA class IV (16%). The study also provided mean BNP levels for patients with different E/E' ratios.
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Mozaffarian D. Chapter 56: Heart Failure. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, editors. Harrison's Principles of Internal Medicine. 20th ed. New York: McGraw Hill Medical; 2018. p. 340-357.
Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography. Eur J Echocardiogr. 2009 Mar;10(2):165-93. doi: 10.1093/ejechocard/jep007. PubMed PMID: 19270053
Little WC, Oh JK. Echocardiographic evaluation of diastolic function can be used to guide clinical care. Circulation. 2009 Feb 24;119(7):879-90. doi: 10.1161/CIRCULATIONAHA.108.792131. PubMed PMID: 19237667.
Borlaug BA, Redfield MM. Diastolic and systolic heart failure are distinct phenotypes within the heart failure spectrum. Circulation. 2011 Aug 16;123(7):2006-13. doi: 10.1161/CIRCULATIONAHA.110.970589. PubMed PMID: 21555706.
Sohn DW, Chai IH, Lee DJ, Kim HC, Kim HS, Oh BH, et al. Assessment of mitral annulus velocity by Doppler tissue imaging in the evaluation of left ventricular diastolic function. J Am Coll Cardiol. 1997 Sep;30(2):474-80. doi: 10.1016/s0735-1097(97)00144-3. PubMed PMID: 9247497.
Sutherland GR, Di Salvo G, Claus P, D'hooge J, Bijnens B. Strain and strain rate imaging: a new clinical approach to quantifying regional myocardial function. J Am Soc Echocardiogr. 2004 Jul;17(7):788-802. doi: 10.1016/j.echo.2004.03.027. PubMed PMID: 15220868.
Nagueh SF, Middleton KJ, Kopelen HA, Zoghbi WA, Quinones MA. Doppler tissue imaging: a noninvasive technique for evaluation of left ventricular relaxation and estimation of filling pressures. J Am Coll Cardiol. 1997 Sep;30(6):1527-33. doi: 10.1016/s0735-1097(97)00344-6. PubMed PMID: 9362402.
Ommen SR, Nishimura RA, Appleton CP, Miller FA, Oh JK, Redfield MM, et al. Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures: A comparative simultaneous Doppler-catheterization study. Circulation. 2000 Dec 12;102(24):1788-94. doi: 10.1161/01.cir.102.24.1788. PubMed PMID: 11113028.
Maisel AS, Krishnaswamy P, Nowak RM, McCord J, Hollander JE, Duc P, et al. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med. 2002 Jul 18;347(3):161-7. doi: 10.1056/NEJMoa020233. PubMed PMID: 12124404.
Daniels LB, Maisel AS. Natriuretic peptides. J Am Coll Cardiol. 2007 Jan 30;49(4):383-90. doi: 10.1016/j.jacc.2006.10.018. PubMed PMID: 17258094
Lubien E, DeMaria A, Krishnaswamy P, Clopton P, Koon J, Kazanegra R, et al. Utility of B-natriuretic peptide in detecting diastolic dysfunction: comparison with Doppler velocity recordings. Circulation. 2002 Jul 9;105(1):595-601. doi: 10.1161/hc0502.102732. PubMed PMID: 11772882.
Zile MR, Brutsaert DL. New concepts in diastolic dysfunction and diastolic heart failure: Part I: diagnosis, prognosis, and measurements of diastolic function. Circulation. 2002;105(11):1387-1393. doi: 10.1161/hc1102.105264.
Nagueh SF, Smiseth OA, Appleton CP, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2016;29(4):277-314. doi: 10.1016/j.echo.2016.01.011.
Appleton CP, Hatle LK. The natural history of left ventricular filling abnormalities: assessment by two-dimensional and Doppler echocardiography. Echocardiography. 1992 Nov;9(6):437-57. doi: 10.1111/j.1540-8175. 1992.tb01319. x. PubMed PMID: 10147332.
Redfield MM, Jacobsen SJ, Burnett JC Jr, Mahoney DW, Bailey KR, Rodeheffer RJ. Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic. JAMA. 2003 Jul 23;289(24):194-202. doi: 10.1001/jama.289.2.194. PubMed PMID: 12851274.
Mak GS, Sawhney S, Tung R, et al. The effects of race on the predictive value of brain natriuretic peptide in patients with acute heart failure. J Card Fail. 2008;14(3):219-225.
Wang TJ, Larson MG, Levy D, et al. Plasma natriuretic peptide levels and the risk of cardiovascular events and death. N Engl J Med.2004;350(7):65563. doi:10.1056/NEJMoa031994.
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