Prognostic role of echocardiography and brain natriuretic peptide in symptomatic breathless patients in the community.

Abstract:

AIMS:Brain natriuretic peptide (BNP), left ventricular (LV) systolic function, and mitral filling pattern (MFP) are prognostic indicators in patients with heart failure (HF). This study evaluated the potential role of E/Ea for predicting cardiovascular (CV) events in patients with suspected HF. This non-invasive measure of LV filling pressure has been shown to predict outcome in more advanced HF, but not in mild HF in the community. METHODS AND RESULTS:Two hundred and twenty-eight elderly symptomatic general practice patients (dyspnoea/oedema) were recruited and underwent clinical evaluation, NT-proBNP assay, and comprehensive echocardiography. The Kaplan-Meier analysis of time to first CV hospitalization or CV death was performed for 1 year after presentation according to nominated thresholds of LV systolic function, NT-proBNP, MFP, and E/Ea ratio. Mean age was 70.3 +/- 7.3 years, mean NT-proBNP was 111.4 +/- 185.8, and 148 (65%) were female. Twenty-six patients (11%) experienced a CV event within 18 months of baseline (6 deaths and 20 admissions). Time to first CV event predicted by NT-proBNP (P < 0.0001), MFP (P = 0.009), and E:Ea (P = 0.0076), but not EF (P = 0.098). When NT-proBNP was elevated, E:Ea >15 identified a group of patients with lower survival (P < 0.0001). CONCLUSION:Both E/Ea and NT-proBNP predicted hospitalization and when used in a two-step approach (NT-proBNP first, followed by E/Ea), the combination of both (elevated NT-proBNP and elevated E/Ea) identified those patients at highest risk, thus supporting a complementary approach for echocardiography and NT-proBNP in patients with HF symptoms.

journal_name

Eur Heart J

journal_title

European heart journal

authors

Whalley GA,Wright SP,Pearl A,Gamble GD,Walsh HJ,Richards M,Doughty RN

doi

10.1093/eurheartj/ehm647

subject

Has Abstract

pub_date

2008-02-01 00:00:00

pages

509-16

issue

4

eissn

0195-668X

issn

1522-9645

pii

29/4/509

journal_volume

29

pub_type

杂志文章,随机对照试验
  • First myocardial infarction: 5-year survival predicted from routine clinical, laboratory, and radionuclide findings during the acute stage.

    abstract::Five-year survival amongst 485 consecutive patients with their first acute myocardial infarction (AMI) was 78.2%. Univariate survival analysis showed that the following variables during the acute stage were of prognostic significance for survival: signs of left ventricular heart failure, enlarged cardiac volume, pulmo...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:

    authors: Rollag A,Abdelnoor M,Mangschau A,Jonsbu J,Aase O,Erikssen J

    更新日期:1991-09-01 00:00:00

  • Scandinavia's journal for cardiologists and cardiothoracic surgeons.

    abstract::Scandinavian Cardiovascular Journal began as a journal for cardiothoracic surgery, but joining forces with cardiology has increased the impact factor and number of subscribers. ...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:

    authors: Taylor J

    更新日期:2012-09-01 00:00:00

  • Shock in acute myocardial infarction: the Cape Horn for trials?

    abstract::Despite therapeutic improvements, cardiogenic shock (CS) remains the most common cause of death in patients with acute myocardial infarction (AMI). In addition to percutaneous coronary intervention, inotropes, fluids, adjunctive medication, intra-aortic balloon counterpulsation, and also assist devices are widely used...

    journal_title:European heart journal

    pub_type: 杂志文章,评审

    doi:10.1093/eurheartj/ehq220

    authors: Thiele H,Allam B,Chatellier G,Schuler G,Lafont A

    更新日期:2010-08-01 00:00:00

  • Echo Doppler evaluation of right ventricular dysplasia.

    abstract::Two-dimensional echocardiography (2D echo) and Doppler were performed in a group of patients who had a high probability of having right ventricular (RV) dysplasia (left bundle branch block arrhythmias, no signs of cardiopulmonary diseases) and in a group of age-matched normals. 2D echo showed RV morphofunctional abnor...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/10.suppl_d.29

    authors: Iliceto S,Izzi M,De Martino G,Rizzon P

    更新日期:1989-09-01 00:00:00

  • Short-term effects of Italian smoking regulation on rates of hospital admission for acute myocardial infarction.

    abstract:AIMS:We used the hospital discharge records of Piedmont region (northern Italy) to evaluate whether a national law banning smoking in public resulted in a short-term reduction in hospital admissions for acute myocardial infarction (AMI). METHODS AND RESULTS:Rates of admission for AMI before the ban (October-December 2...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/ehl201

    authors: Barone-Adesi F,Vizzini L,Merletti F,Richiardi L

    更新日期:2006-10-01 00:00:00

  • Genes for blood pressure: an opportunity to understand hypertension.

    abstract::Hypertension (HTN) is quantitatively the major cardiovascular risk factor and responsible for ∼50% of cardiovascular morbidity and mortality. Blood pressure (BP) is also a classical complex genetic trait with heritability estimates of 30-50%. Although much is known about BP regulation, the intrinsic origin of essentia...

    journal_title:European heart journal

    pub_type: 杂志文章,评审

    doi:10.1093/eurheartj/ehs455

    authors: Ehret GB,Caulfield MJ

    更新日期:2013-04-01 00:00:00

  • Indices of effectiveness of medical and surgical treatment in 40 cases of prosthetic valve endocarditis.

    abstract::Forty patients with prosthetic valve endocarditis (PVE) presenting during a 12-year period at a single hospital were studied. Twenty-six were male and 14 female and ages ranged from 19 to 67 years. During the first six post-operative months, most episodes were caused by staphylococci (38%) and Gram negative bacilli (2...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/5.suppl_c.133

    authors: Gayet JL,Etienne J,Malquarti V,Gruer LD,Didier B,Chuzel M,Champsaur G,Chassignolle J,Fleurette J,Delaye J

    更新日期:1984-10-01 00:00:00

  • Prognostic value of plasma neuropeptide-Y in coronary care unit patients with and without acute myocardial infarction.

    abstract::Plasma neuropeptide Y-like immunoreactivity (NPY-LI) is elevated in patients with acute myocardial ischaemia and congestive heart failure (CHF) owing to increased activity of the sympathetic nervous system. The prognostic value of plasma NPY-LI with regard to mortality was studied in 324 random patients admitted to a ...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/oxfordjournals.eurheartj.a060526

    authors: Ullman B,Hulting J,Lundberg JM

    更新日期:1994-04-01 00:00:00

  • Prasugrel achieves greater inhibition of platelet aggregation and a lower rate of non-responders compared with clopidogrel in aspirin-treated patients with stable coronary artery disease.

    abstract:AIMS:This study was designed to compare the degree of inhibition of platelet aggregation (IPA) of prasugrel with that of clopidogrel in stable aspirin-treated patients with coronary artery disease (CAD). METHODS AND RESULTS:Subjects (n=101) were randomly assigned to the following loading dose (LD) (day 1)/maintenance ...

    journal_title:European heart journal

    pub_type: 杂志文章,随机对照试验

    doi:10.1093/eurheartj/ehi877

    authors: Jernberg T,Payne CD,Winters KJ,Darstein C,Brandt JT,Jakubowski JA,Naganuma H,Siegbahn A,Wallentin L

    更新日期:2006-05-01 00:00:00

  • Anomalous coronary arteries coursing between the aorta and pulmonary trunk: clinical indications for coronary artery bypass.

    abstract::Coronary arteries of anomalous origin with subsequent coursing between the aorta and pulmonary trunk can cause ischaemia, infarction or sudden death. However, reports of surgical correction are sparse due to the rarity of ante-mortem diagnosis. We report two cases in which symptoms were related to anomalous origin of ...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/12.7.832

    authors: Thomas D,Salloum J,Montalescot G,Drobinski G,Artigou JY,Grosgogeat Y

    更新日期:1991-07-01 00:00:00

  • Cardiac hypertrophy and function in asymptomatic acromegaly.

    abstract::Heart disease frequently occurs in advanced acromegaly. In order to investigate cardiac mass and function in acromegaly in the absence of obvious cardiac disease, we performed Doppler echocardiography in 15 asymptomatic acromegalic patients (six of them had systemic hypertension). The data were compared with those of ...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:

    authors: Morvan D,Komajda M,Grimaldi A,Turpin G,Grosgogeat Y

    更新日期:1991-06-01 00:00:00

  • Sudden cardiac death while taking amiodarone therapy: the role of abnormal repolarization.

    abstract::Torsade de pointes may occur as a complication of amiodarone therapy. We report a patient receiving amiodarone who was resuscitated from cardiovascular collapse and documented ventricular fibrillation. At subsequent electrophysiology study, while the patient was taking amiodarone therapy, monophasic action potentials ...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/oxfordjournals.eurheartj.a059849

    authors: Morgan JM,Lopes A,Rowland E

    更新日期:1991-10-01 00:00:00

  • Microalbuminuria during acute myocardial infarction; a strong predictor for 1-year mortality.

    abstract:AIMS:Urinary albumin excretion increases during acute myocardial infarction but little is known on the prognostic significance and the pathophysiological mechanisms of microalbuminuria in this clinical setting. The primary aim of the study was to examine whether urinary albumin excretion has predictive power for 1-year...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1053/euhj.2000.2582

    authors: Berton G,Cordiano R,Palmieri R,Cucchini F,De Toni R,Palatini P

    更新日期:2001-08-01 00:00:00

  • Does coronary angioplasty replace, delay, or complement aortocoronary bypass surgery?

    abstract::In single vessel disease angioplasty can replace surgery in the majority of patients. In cases of recurrence at the site of angioplasty or in the case of progression elsewhere, a second intervention can be performed. Thus, in the majority of patients surgery can be replaced; in the minority it can be delayed. In patie...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/8.suppl_f.47

    authors: Kaltenbach M

    更新日期:1987-09-01 00:00:00

  • Very long-term survival and late sudden cardiac death in cardiac resynchronization therapy patients.

    abstract:AIMS:The very long-term outcome of patients who survive the first few years after receiving cardiac resynchronization therapy (CRT) has not been well described thus far. We aimed to provide long-term outcomes, especially with regard to the occurrence of sudden cardiac death (SCD), in CRT patients without (CRT-P) and wi...

    journal_title:European heart journal

    pub_type: 杂志文章,多中心研究

    doi:10.1093/eurheartj/ehz238

    authors: Barra S,Duehmke R,Providência R,Narayanan K,Reitan C,Roubicek T,Polasek R,Chow A,Defaye P,Fauchier L,Piot O,Deharo JC,Sadoul N,Klug D,Garcia R,Dockrill S,Virdee M,Pettit S,Agarwal S,Borgquist R,Marijon E,Boveda

    更新日期:2019-07-01 00:00:00

  • Heart failure syndrome. Rationale for current drug treatment.

    abstract::In the initial phase of heart failure, cardiac output and pressure are maintained by increasing sympathetic drive and by cell hypertrophy. Elevated end-diastolic volume, a reduced ejection fraction and a higher filling pressure also occur. Only in more severe heart failure, when cardiac output cannot be maintained, do...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/16.suppl_f.2

    authors: Burkart F

    更新日期:1995-07-01 00:00:00

  • 24-h ECG monitoring in patients with rheumatoid arthritis.

    abstract::Although the main cardiac complication in patients with rheumatoid arthritis is subclinical pericarditis, mononuclear cell infiltrations into myocardium may cause cardiac arrhythmias and conduction defects. In order to examine these problems we evaluated 70 patients (53 women and 17 men) aged 18-83 years (average 56.7...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/oxfordjournals.eurheartj.a061005

    authors: Tłustochowicz W,Piotrowicz R,Cwetsch A,Raczka A,Kramarz E,Nowak J

    更新日期:1995-06-01 00:00:00

  • Patient differences related to management in general practice and the hospital: a cross-sectional study of heart failure in the community.

    abstract:AIM:To compare patients treated for heart failure in relation to the management in general practices versus hospital admission. METHODS AND RESULTS:Twelve randomly selected general practices (GP) were screened for patients receiving ACE-inhibitor, digoxin, or loop diuretic treatment. The first 500 volunteers of 959 po...

    journal_title:European heart journal

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.ehj.2004.06.033

    authors: Nielsen OW,McDonagh T,Cowburn P,Blue L,Robb SD,Dargie H

    更新日期:2004-10-01 00:00:00

  • Prevalence and mechanism of streptokinase-induced platelet stimulation. Effect of acetylsalicylic acid.

    abstract::It was recently shown that streptokinase may induce clot formation in vivo by immunoglobulin G mediated platelet stimulation. We evaluated the in vitro effect of streptokinase on platelet function in 103 subjects, of whom 52 were < or = 30 years and 51 were > or = 50 years old. Although streptokinase inhibited platele...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/oxfordjournals.eurheartj.a060094

    authors: Terres W,Krüger K,Bleifeld W

    更新日期:1992-11-01 00:00:00

  • Lipoprotein-associated phospholipase A2 activity and risk of heart failure: The Rotterdam study.

    abstract:AIMS:Evidence is accumulating that inflammation plays a role in the pathophysiology of heart failure. Lipoprotein-associated phospholipase A2 (Lp-PLA2) has pro-inflammatory properties. We investigated whether Lp-PLA2 activity is associated with heart failure. METHODS AND RESULTS:Lp-PLA2 activity was determined in a ra...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/ehl230

    authors: van Vark LC,Kardys I,Bleumink GS,Knetsch AM,Deckers JW,Hofman A,Stricker BH,Witteman JC

    更新日期:2006-10-01 00:00:00

  • Left atrial ball thrombus in combined mitral-aortic valve disease.

    abstract::This report describes a patient with left atrial ball thrombus which was detected during echocardiographic evaluation of combined mitral-aortic valve disease. Surgical correction was performed entirely on the basis of the echocardiographic diagnosis. ...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/oxfordjournals.eurheartj.a060161

    authors: Schäfer RO,Evers G,Morgan P,Thiel H

    更新日期:1992-02-01 00:00:00

  • Advanced heart failure: feasibility study of long-term continuous axial flow pump support.

    abstract:AIMS:A lack of donor hearts has stimulated interest in using blood pumps to treat severe heart failure. We tested the hypothesis that a new continuous flow circulatory assist device could be employed safely to relieve symptoms of heart failure and evaluated the potential to prolong life. METHODS AND RESULTS:An intraca...

    journal_title:European heart journal

    pub_type: 杂志文章,多中心研究

    doi:10.1093/eurheartj/ehi163

    authors: Siegenthaler MP,Westaby S,Frazier OH,Martin J,Banning A,Robson D,Pepper J,Poole-Wilson P,Beyersdorf F

    更新日期:2005-05-01 00:00:00

  • Thin-cap fibroatheroma and microchannel findings in optical coherence tomography correlate with subsequent progression of coronary atheromatous plaques.

    abstract:AIMS:Morphological characteristics of non-significant coronary plaques (NSCPs) that develop rapid progression have not been fully elucidated. The aim of this study was to clarify the morphological characteristics of NSCPs in patients with coronary artery disease (CAD) using intravascular optical coherence tomography (O...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/ehr284

    authors: Uemura S,Ishigami K,Soeda T,Okayama S,Sung JH,Nakagawa H,Somekawa S,Takeda Y,Kawata H,Horii M,Saito Y

    更新日期:2012-01-01 00:00:00

  • Comparative study of echo- and angiocardiographically determined regional left ventricular wall motion in recent myocardial infarction.

    abstract::We have studied regional left ventricular (LV) wall motion with M-mode, cross-sectional (2D) echocardiography and LV angiography in 50 patients with a recent myocardial infarction. Regional LV wall motion was evaluated according to a 9-segment model. 2D echocardiography permitted information from all, M-mode echocardi...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/oxfordjournals.eurheartj.a061703

    authors: Lindvall K,Hamsten A,Landou C,Szamosi A,de Faire U

    更新日期:1984-07-01 00:00:00

  • Cardiovascular disease in Europe: epidemiological update.

    abstract::This overview provides a Europe-wide update on the current burden of cardiovascular disease, and specifically of coronary heart disease and stroke. Cardiovascular disease continues to cause a large proportion of deaths and disability in Europe, and places a substantial burden on the health care systems and economies o...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/eht356

    authors: Nichols M,Townsend N,Scarborough P,Rayner M

    更新日期:2013-10-01 00:00:00

  • The effect of habitual sustained endurance exercise on cardiac structure and function.

    abstract::We performed echocardiographic evaluation of 20 male veteran endurance runners (mean age 56 +/- 7 years) and compared them with a group of age-matched controls. All the runners had run at least 25 miles per week for more than 25 years. Although only four athletes showed voltage ECG evidence of left ventricular hypertr...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/oxfordjournals.eurheartj.a059585

    authors: Northcote RJ,McKillop G,Todd IC,Canning GP

    更新日期:1990-01-01 00:00:00

  • Avoiding non-responders to cardiac resynchronization therapy: a practical guide.

    abstract::Over two decades after the introduction of cardiac resynchronization therapy (CRT) into clinical practice, ∼30% of candidates continue to fail to respond to this highly effective treatment of drug-refractory heart failure (HF). Since the causes of this non-response (NR) are multifactorial, it will require multidiscipl...

    journal_title:European heart journal

    pub_type: 杂志文章,评审

    doi:10.1093/eurheartj/ehw270

    authors: Daubert C,Behar N,Martins RP,Mabo P,Leclercq C

    更新日期:2017-05-14 00:00:00

  • Prognostic relevance of symptoms versus objective evidence of coronary artery disease in diabetic patients.

    abstract:AIM:Little is known about the prognostic significance of silent versus symptomatic coronary artery disease (CAD) in diabetic patients. We therefore assessed the incidence of scintigraphic evidence of CAD in diabetic patients without known CAD and the impact of symptoms and scintigraphic findings on prognosis. METHODS ...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1016/j.ehj.2004.02.013

    authors: Zellweger MJ,Hachamovitch R,Kang X,Hayes SW,Friedman JD,Germano G,Pfisterer ME,Berman DS

    更新日期:2004-04-01 00:00:00

  • Platelet and leukocyte activation after myocardial infarction. Influence of enalapril.

    abstract::In this double-blind placebo-controlled study with enalapril, 74 patients with acute myocardial infarction were followed at 0, 7, 30, 60 and 180 days after the event. Platelets and leukocytes were activated during the first 7 days. During the 6-month period fibrinogen, leukocytes, elastase, and B beta 30-43 remained e...

    journal_title:European heart journal

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/oxfordjournals.eurheartj.a060831

    authors: Sylvén C,Hagerman I,Karlberg KE,Chen J,Wallin R,Eneroth P,Bergström K,Saldeen T

    更新日期:1995-12-01 00:00:00

  • The effect of correcting for troponins on trends in coronary heart disease events in Finland during 1993-2002: the FINAMI study.

    abstract:AIMS:The object of this study is to analyse the trends in coronary events in Finland during 1993-2002, correcting for the effect of troponins. METHODS AND RESULTS:A population-based myocardial infarction register recorded all coronary events (n=14 782) in four geographical areas of Finland during 1993-2002. Correction...

    journal_title:European heart journal

    pub_type: 杂志文章,多中心研究

    doi:10.1093/eurheartj/ehl120

    authors: Salomaa V,Ketonen M,Koukkunen H,Immonen-Räihä P,Lehtonen A,Torppa J,Kuulasmaa K,Kesäniemi YA,Pyörälä K,FINAMI Study Group.

    更新日期:2006-10-01 00:00:00