Characterization of Left Ventricular Filling Abnormalities and Its Relation to Elevated Plasma Brain Natriuretic Peptide Level in Acute to Chronic Diastolic Heart Failure

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Author(s)

    • NAKAO Shinji
    • Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine
    • GODA Akiko
    • Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine
    • YUBA Masao
    • Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine
    • OTSUKA Misato
    • Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine
    • MATSUMOTO Mika
    • Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine
    • YOSHIDA Chikako
    • Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine
    • OHYANAGI Mitsumasa
    • Division of Coronary Heart Disease, Department of Internal Medicine, Hyogo College of Medicine
    • NAITO Yoshiro
    • Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine
    • LEE Masaaki
    • Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine
    • TSUJINO Takeshi
    • Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine
    • MASUYAMA Tohru
    • Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine

Abstract

<b>Background</b> Although Doppler left ventricular (LV) filling abnormalities have been extensively analyzed in patients with systolic heart failure (SHF), they have not yet been well characterized in patients with acute to chronic diastolic heart failure (DHF) in the light of plasma brain natriuretic peptide (BNP) levels. <b>Methods and Results</b> In 25 patients presenting with acute DHF and 25 with acute SHF, echo Doppler parameters and plasma BNP levels were obtained on admission and in the chronic stage. The mitral E/A ratio was lower in DHF patients than in SHF patients in the acute stage (1.3 ±0.4 vs 1.8±0.9, p<0.05), and in the chronic stage of DHF the ratio decreased with plasma BNP level, but plasma BNP level was still greater than 100 pg/ml in 15 patients (60%). Among patients with DHF the plasma BNP level did not correlate with the mitral E/A ratio or deceleration time (r=0,25, p=NS; r=0,23, p=NS), but did with estimated pulmonary artery systolic pressure (r=0.64, p<0.01). <b>Conclusions</b> A restrictive mitral flow velocity pattern is observed in only 25% of patients with DHF, so it is particularly important to recognize pseudonormalization in those with possible DHF. Persistently elevated plasma BNP level is not primarily caused by LV diastolic dysfunction, but by secondary alteration for hemodynamic adjustment (elevated LV end-diastolic pressure) in patients with DHF. (<i>Circ J</i> 2007; <b>71:</b> 1412 - 1417)<br>

Journal

  • Circulation Journal

    Circulation Journal 71(9), 1412-1417, 2007-08-20

    Japanese Circulation Society

References:  31

Cited by:  5

Codes

  • NII Article ID (NAID)
    110006399687
  • NII NACSIS-CAT ID (NCID)
    AA11591968
  • Text Lang
    ENG
  • Article Type
    Journal Article
  • ISSN
    13469843
  • Data Source
    CJP  CJPref  NII-ELS  J-STAGE 
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