Diagnostic accuracy of N-terminal pro-brain natriuretic peptide in the evaluation of postoperative left ventricular diastolic dysfunction
Küçük Resim Yok
Tarih
2008
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Texas Heart Inst
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
We compared the diagnostic accuracy of N-terminal prohormone brain natriuretic peptide (NT-proBNP) with that of echocardiography in the evaluation of left ventricular diasrolic dysfunction after coronary artery bypass grafting. Thirty patients were studied prospectively. Patients who had recent myocardial infarction, unstable angina pectoris, or low ejection fraction with systolic dysfunction were excluded. Two blood samples were obtained: before anesthetic induction and on the 7th postoperative day Levels of NT-proBNP were measured by electrochemiluminescence immunoassay. Comprehensive echocardiographic Doppler examinations were performed on admission and on the 7th postoperative day Relationships between NT-proBNP levels and echocardiographic indices were evaluated by correlation, multiple linear regression, and receiver-operating characteristic curve analysis. There were significant and correlated worsenings in diastolic stage as determined both by echocardiographic indices and NT-proBNP levels. Early transmitral-to-early diastolic annular velocity ratio (E/Ea) was found to correlate with both NT-proBNP and postoperative diastolic functional stage (r=0.78, P < 0.001). Mitral E/Ea was significantly more sensitive than were NT-proBNP levels in predicting diastolic functional stage. The area under the receiver-operating characteristic curve for NT-proBNP was significantly lower than that of mitral E/Ea (mean difference, 0. 12; P=0. 024). The NT-proBNP had 87 5% sensitivity and 55% specificity, whereas E/Ea had 87 5% sensitivity and 86.4 % specificity. Plasma NT-proBNP levels are significantly related to mitral E/Ea ratio, which is a predictor of diastolic stage. Therefore, elevated NT-proBNP levels may indicate the time for a Doppler echocardiographic evaluation and identify a subgroup of patients at high risk who need closer monitoring during the early postoperative period.
Açıklama
Anahtar Kelimeler
diastole/physiology, echocardiography, heart ventricles, left ventricular dysfunction, myocardial ischemia/diagnosis natriuretic peptide brain/blood/ diagnostic use, predictive value of tests, pro-brain natriuretic peptide, sensitivity and specificity, ventricular dysfunction, left/blood/diagnosis/physiology
Kaynak
Texas Heart Institute Journal
WoS Q Değeri
N/A
Scopus Q Değeri
Q3
Cilt
35
Sayı
2
