TY - JOUR

T1 - Preclinical systolic and diastolic dysfunction assessed by tissue Doppler imaging is associated with elevated plasma pro-B-type natriuretic peptide concentrations

AU - Mogelvang, Rasmus

AU - Goetze, Jens P

AU - Pedersen, Sune A

AU - Olsen, Niels T

AU - Marott, Jacob L

AU - Schnohr, Peter

AU - Sogaard, Peter

AU - Jensen, Jan S

AU - Mogelvang, Rasmus

AU - Goetze, Jens P

AU - Pedersen, Sune A

AU - Olsen, Niels T

AU - Marott, Jacob L

AU - Schnohr, Peter

AU - Søgaard, Peter

AU - Jensen, Jan S

N1 - Keywords: Adult; Aged; Biological Markers; Blood Pressure; Cardiovascular Diseases; Cohort Studies; Diastole; Echocardiography; Echocardiography, Doppler, Color; Female; Humans; Longitudinal Studies; Male; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; Residence Characteristics; Systole Times Cited: 1ArticleEnglishMogelvang, RGentofte Univ Hosp, Dept Cardiol, Post 4210,65 Niels Andersens Vej, DK-2900 Hellerup, DenmarkCited References Count: 41482OACHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERSCURTIS CENTER, INDEPENDENCE SQUARE WEST, PHILADELPHIA, PA 19106-3399 USAPHILADELPHIA

PY - 2009/8/1

Y1 - 2009/8/1

N2 - BACKGROUND: Heart failure is a major public health problem. To improve its grave prognosis, early identification of cardiac dysfunction is mandatory. Conventional echocardiography is not suitable for this. Tissue Doppler imaging (TDI), however, could be so. METHODS AND RESULTS: Within a large community-based population-study (n = 1012), cardiac function was evaluated by conventional echocardiography (left ventricular hypertrophy, dilatation, systolic, and severe diastolic dysfunction), TDI, and plasma proBNP. Averages of peak systolic (s'), early diastolic (e'), and late diastolic (a') velocities from 6 mitral annular sites were used. TDI was furthermore quantified by a combined index (eas-index) of diastolic and systolic performance: e'/(a' x s'). Compared with controls, persons with elevated plasma proBNP concentrations (n = 100) displayed lower systolic and diastolic performance by TDI, in terms of lower s' (P = 0.017) and a' (P < .001), and higher e'/a' (P = .002) and eas-index (P < .001). This pattern remained significant after multivariable adjustment for age, sex, body mass index, heart rate, estimated glomerular filtration rate, hypertension, diabetes, ischemic heart disease, and conventional echocardiography. Furthermore, TDI provided incremental information over conventional echocardiography in predicting elevated plasma proBNP concentrations. CONCLUSIONS: Preclinical systolic and diastolic dysfunction by TDI is associated with elevated plasma proBNP levels, even when conventional echocardiography is normal.

AB - BACKGROUND: Heart failure is a major public health problem. To improve its grave prognosis, early identification of cardiac dysfunction is mandatory. Conventional echocardiography is not suitable for this. Tissue Doppler imaging (TDI), however, could be so. METHODS AND RESULTS: Within a large community-based population-study (n = 1012), cardiac function was evaluated by conventional echocardiography (left ventricular hypertrophy, dilatation, systolic, and severe diastolic dysfunction), TDI, and plasma proBNP. Averages of peak systolic (s'), early diastolic (e'), and late diastolic (a') velocities from 6 mitral annular sites were used. TDI was furthermore quantified by a combined index (eas-index) of diastolic and systolic performance: e'/(a' x s'). Compared with controls, persons with elevated plasma proBNP concentrations (n = 100) displayed lower systolic and diastolic performance by TDI, in terms of lower s' (P = 0.017) and a' (P < .001), and higher e'/a' (P = .002) and eas-index (P < .001). This pattern remained significant after multivariable adjustment for age, sex, body mass index, heart rate, estimated glomerular filtration rate, hypertension, diabetes, ischemic heart disease, and conventional echocardiography. Furthermore, TDI provided incremental information over conventional echocardiography in predicting elevated plasma proBNP concentrations. CONCLUSIONS: Preclinical systolic and diastolic dysfunction by TDI is associated with elevated plasma proBNP levels, even when conventional echocardiography is normal.

U2 - 10.1016/j.cardfail.2009.01.005

DO - 10.1016/j.cardfail.2009.01.005

M3 - Journal article

C2 - 19643359

VL - 15

SP - 489

EP - 495

JO - Journal of Cardiac Failure

JF - Journal of Cardiac Failure

SN - 1071-9164

IS - 6

ER -