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

• 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

抄録

Background 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. Methods and Results 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). Conclusions 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. (Circ J 2007; 71: 1412 - 1417)<br>

収録刊行物

• Circulation Journal

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

  一般社団法人 日本循環器学会

キーワード

• Brain natriuretic peptide
• Diastole
• Heart failure
• Mitral flow

詳細情報

• CRID: 1390001205103630208
• NII論文ID: 110006399687
• NII書誌ID: AA11591968
• DOI: 10.1253/circj.71.1412
• COI: 1:CAS:528:DC%2BD2sXhtFSltbrE
• ISSN: 13474820
• ISSN: 13469843
• PubMed: 17721020
• Web Site: http://www.jstage.jst.go.jp/article/circj/71/9/71_9_1412/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2008113385
• 本文言語コード: en
• データソース種別:
  • JaLC
  • Crossref
  • PubMed
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可