Abstract:
OBJECTIVES:This study was designed to determine the prognostic importance of left ventricular (LV) myocardial stiffness, a hemodynamic index which is closely related to B-type natriuretic peptide (BNP) concentration in patients with congestive heart failure (CHF). BACKGROUND:While elevated BNP, an abnormality of cardiac neurohormones, is known to be an independent marker of death or re-admission, it remains to be clarified whether there is also a strong predictor directly related to cardiac dysfunction. METHODS:LV performance variables and stress-strain analyses including diastolic myocardial stiffness constant (K(m)) were obtained from 37 patients with initial CHF by the combined simultaneous measurement of echocardiographic and hemodynamic data. Survivors were monitored for a mean of 23 months, with the main endpoint being combined death or first re-admission for CHF. RESULTS:Ten patients (27%) were primary endpoint cases. Both K(m) and plasma BNP levels were higher in the event than in the event-free group. By Cox proportional hazards analysis, K(m)≥4.0 was identified as the only variable with significant and independently incremental predictive power to affect the primary endpoint (adjusted hazard ratio=7.354, 95% confidence interval 1.379-39.232, p=0.02). CONCLUSIONS:In patients with CHF, increased myocardial stiffness may have greater prognostic significance compared to other conventional predictors. Increased myocardial stiffness may be considered to be an important prognostic factor independent of the loading conditions.
journal_name
J Cardioljournal_title
Journal of cardiologyauthors
Watanabe S,Shite J,Takaoka H,Shinke T,Tanino Y,Otake H,Matsumoto D,Ogasawara D,Sawada T,Hirata K,Yokoyama Mdoi
10.1016/j.jjcc.2011.07.005subject
Has Abstractpub_date
2011-11-01 00:00:00pages
245-52issue
3eissn
0914-5087issn
1876-4738pii
S0914-5087(11)00127-4journal_volume
58pub_type
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