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Independent prognostic value of echocardiography and N-terminal pro-B-type natriuretic peptide in patients with heart failure.

Publication ,  Journal Article
Hinderliter, AL; Blumenthal, JA; O'Conner, C; Adams, KF; Dupree, CS; Waugh, RA; Bensimhon, D; Christenson, RH; Sherwood, A
Published in: Am Heart J
December 2008

BACKGROUND: Echocardiographic indices of cardiac structure and function and natriuretic peptide levels are strong predictors of mortality in patients with heart failure. Whether cardiac ultrasound and natriuretic peptides provide independent prognostic information is uncertain. METHODS: Echocardiograms and measurements of N-terminal pro-brain natriuretic peptide (NT-proBNP) were prospectively performed in 211 patients with left ventricular systolic dysfunction who were followed for a median of 4 years. Echocardiographic variables and NT-proBNP were examined as predictors of all-cause mortality in univariable and multivariable proportional hazards models. RESULTS: Participants averaged 57 years old (SD 12 years) and had a mean left ventricular ejection fraction of 32% (SD 11%). A total of 71 patients (34%) died during the follow-up period. N-terminal pro-brain natriuretic peptide was a strong predictor of mortality (P < .001) as were multiple echocardiographic measures. In models that included age and NT-proBNP, with other clinical variables eligible for entry by stepwise selection, significant predictors of death included left ventricular ejection fraction (P = .013) and end-diastolic volume (P < .001), left atrial volume index (P = .005), right atrial volume index (P = .003), and tricuspid regurgitation area (P = .015). In models that also included left ventricular ejection fraction, end-diastolic volume of the left ventricle (P = .019), left atrial volume (P = .026), and right atrial volume (P = .020) remained significant predictors of mortality. CONCLUSIONS: Left ventricular size and function and left atrial and right atrial sizes are significant predictors of all-cause mortality in patients with heart failure, independent of NT-proBNP levels and other clinical variables.

Duke Scholars

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

December 2008

Volume

156

Issue

6

Start / End Page

1191 / 1195

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Left
  • Tricuspid Valve Insufficiency
  • Prospective Studies
  • Proportional Hazards Models
  • Prognosis
  • Peptide Fragments
  • North Carolina
  • Natriuretic Peptide, Brain
  • Middle Aged
  • Male
 

Citation

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ICMJE
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Hinderliter, A. L., Blumenthal, J. A., O’Conner, C., Adams, K. F., Dupree, C. S., Waugh, R. A., … Sherwood, A. (2008). Independent prognostic value of echocardiography and N-terminal pro-B-type natriuretic peptide in patients with heart failure. Am Heart J, 156(6), 1191–1195. https://doi.org/10.1016/j.ahj.2008.07.022
Hinderliter, Alan L., James A. Blumenthal, Christopher O’Conner, Kirkwood F. Adams, Carla Sueta Dupree, Robert A. Waugh, Daniel Bensimhon, Robert H. Christenson, and Andrew Sherwood. “Independent prognostic value of echocardiography and N-terminal pro-B-type natriuretic peptide in patients with heart failure.Am Heart J 156, no. 6 (December 2008): 1191–95. https://doi.org/10.1016/j.ahj.2008.07.022.
Hinderliter AL, Blumenthal JA, O’Conner C, Adams KF, Dupree CS, Waugh RA, et al. Independent prognostic value of echocardiography and N-terminal pro-B-type natriuretic peptide in patients with heart failure. Am Heart J. 2008 Dec;156(6):1191–5.
Hinderliter, Alan L., et al. “Independent prognostic value of echocardiography and N-terminal pro-B-type natriuretic peptide in patients with heart failure.Am Heart J, vol. 156, no. 6, Dec. 2008, pp. 1191–95. Pubmed, doi:10.1016/j.ahj.2008.07.022.
Hinderliter AL, Blumenthal JA, O’Conner C, Adams KF, Dupree CS, Waugh RA, Bensimhon D, Christenson RH, Sherwood A. Independent prognostic value of echocardiography and N-terminal pro-B-type natriuretic peptide in patients with heart failure. Am Heart J. 2008 Dec;156(6):1191–1195.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

December 2008

Volume

156

Issue

6

Start / End Page

1191 / 1195

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Left
  • Tricuspid Valve Insufficiency
  • Prospective Studies
  • Proportional Hazards Models
  • Prognosis
  • Peptide Fragments
  • North Carolina
  • Natriuretic Peptide, Brain
  • Middle Aged
  • Male