Abstract | AIMS: METHODS AND RESULTS: We prospectively included 611 patients with acute myocardial infarction admitted to a tertiary centre and performed echocardiography within 48 h of admission. Global longitudinal myocardial function was assessed by two-dimensional speckle tracking simultaneously with measurement of plasma NT-proBNP. A significant linear relationship between NT-proBNP and global longitudinal strain (GLS) was found (P < 0.0001, r = 0.62). Weaker correlation was found between NT-proBNP and left ventricular ejection fraction (LVEF; P < 0.0001, r = - 0.44). GLS emerged on multivariable analysis including age, sex, estimated glomerular filtration rate, Killip class ≥2, diabetes, hypertension, presence of ST segment elevation, anterior infarction, troponin level, left atrial volume index, mitral valve deceleration time, and E/e' as the strongest predictor of log( NT-proBNP) (P < 0.0001). In patients with preserved systolic function (LVEF >45%), GLS remained strongly correlated with NT-proBNP (P < 0.0001, r = 0.50). The C-statistic associated with prediction of upper vs. lower quartiles of NT-proBNP was significantly higher for GLS compared with LVEF (0.76 vs. 0.56; P < 0.0001). CONCLUSION: Left ventricular longitudinal function assessed by GLS exhibits a stronger association with NT-proBNP levels in acute myocardial infarction compared with LVEF. In patients with apparently preserved systolic function, GLS is superior to LVEF in identifying increased neurohormonal activation.
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Authors | Mads Ersbøll, Nana Valeur, Ulrik Madvig Mogensen, Mads Andersen, Rasmus Greibe, Jacob Eifer Møller, Christian Hassager, Peter Søgaard, Lars Køber |
Journal | European journal of heart failure
(Eur J Heart Fail)
Vol. 14
Issue 10
Pg. 1121-9
(Oct 2012)
ISSN: 1879-0844 [Electronic] England |
PMID | 22753861
(Publication Type: Journal Article)
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Chemical References |
- Peptide Fragments
- pro-brain natriuretic peptide (1-76)
- Natriuretic Peptide, Brain
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Topics |
- Aged
- Cohort Studies
- Echocardiography
(methods)
- Female
- Heart
(physiopathology)
- Humans
- Male
- Middle Aged
- Multivariate Analysis
- Myocardial Infarction
(diagnostic imaging, metabolism, physiopathology)
- Natriuretic Peptide, Brain
(metabolism)
- Peptide Fragments
(metabolism)
- Prospective Studies
- Stroke Volume
- Ventricular Dysfunction, Left
(diagnostic imaging, metabolism, physiopathology)
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