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

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
Christian BruchThomas Wichter

Abstract

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). In all, 73 patients with CHF 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. 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). In patients wi...Continue Reading

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Citations

Aug 30, 2008·Circulation Journal : Official Journal of the Japanese Circulation Society·Hyungseop KimKwon-Bae Kim
Sep 18, 2013·The International Journal of Cardiovascular Imaging·Cristian MornoşDragoş Cozma
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Apr 27, 2017·European Heart Journal Cardiovascular Imaging·Patrizio LancellottiBogdan A Popescu

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