ORIGINAL PAPER
Correlation analysis of the relationship between B-type natriuretic peptide and selected echocardiographic parameters in patients with permanent pacemakers
Submission date: 2015-07-28
Final revision date: 2015-09-18
Acceptance date: 2015-09-28
Publication date: 2016-01-11
Medical Studies 2015;31(4):241-248
KEYWORDS
TOPICS
ABSTRACT
Introduction: The present study was undertaken to evaluate the practical value of BNP measurements and echocardiographic left ventricular volume index in patients with permanent pacemakers because there are no such reports in the literature.
Aim of the research: The aim of the study was to reveal multiple correlations between BNP levels and selected echocardiographic parameters of the left atrium in patients with permanent pacemakers. In the literature there are reports on the significance of BNP values and left atrial size in patients with permanent pacemakers. The results of the present study appear to be of value in the outpatient assessment of these patients.
Material and methods: We analysed a group of 117 patients with permanent pacemakers (AAI/R 21 patients, DDD/R 59 patients, VVI/R 37 patients) and 48 healthy volunteers serving as the control group. BNP measurements were performed on venous blood samples using Triage meters. The Simpson method and the ellipse method were used to assess the left atrium on echocardiography.
Results: There was a significant correlation between BNP and maximum left atrial volume, minimum left atrial volume, and left atrial volume index in patients with AAI/R, DDD/R, and VVI/R pacemakers at 3 and 6 months after the implantation.
Conclusions: In patients after implantation of permanent pacemakers there are correlations between BNP values and echocardiographic left atrial parameters, especially in patients with DDD/R pacemakers. Left atrial function improves in patients with DDD/R pacemakers. Pacemaker check-up should be extended to include BNP measurements and echocardiographic assessment of the left atrium.
Aim of the research: The aim of the study was to reveal multiple correlations between BNP levels and selected echocardiographic parameters of the left atrium in patients with permanent pacemakers. In the literature there are reports on the significance of BNP values and left atrial size in patients with permanent pacemakers. The results of the present study appear to be of value in the outpatient assessment of these patients.
Material and methods: We analysed a group of 117 patients with permanent pacemakers (AAI/R 21 patients, DDD/R 59 patients, VVI/R 37 patients) and 48 healthy volunteers serving as the control group. BNP measurements were performed on venous blood samples using Triage meters. The Simpson method and the ellipse method were used to assess the left atrium on echocardiography.
Results: There was a significant correlation between BNP and maximum left atrial volume, minimum left atrial volume, and left atrial volume index in patients with AAI/R, DDD/R, and VVI/R pacemakers at 3 and 6 months after the implantation.
Conclusions: In patients after implantation of permanent pacemakers there are correlations between BNP values and echocardiographic left atrial parameters, especially in patients with DDD/R pacemakers. Left atrial function improves in patients with DDD/R pacemakers. Pacemaker check-up should be extended to include BNP measurements and echocardiographic assessment of the left atrium.
REFERENCES (40)
1.
Emdin M, Vittorini S, Passino C, et al. Old and new biomarkers of heart failure. Eur J Heart Fail 2009; 4: 331-5.
2.
Luchner A, Möckel M, Spanuth E, et al. N-terminal pro brain natriuretic peptide in the management of patients in the medical emergency department (PROMPT) correlation with disease severity, utilisation of hospital resources, and prognosis in a large, prospective, randomized multocentre trial. Eur J Heart Fail 2012; 3: 259-67.
3.
Lam LL, Cameron PA, Schneider HG, et al. Meta-analysis effect of B-type natriuretic peptide testing on clinical outcomes in patients with acute dyspnea in the emergency setting. Ann Intern Med 2010; 11: 728-35.
4.
Cheng V, Kazanagra R, Gracia A, et al. A rapid bedside test for B type peptide predicts treatment outcomes in patients admitted for decompensated heart failure: a pilot study. J Am Coll Cardiol 2001; 37: 386-91.
5.
Meisel AS, Krishnaswamy P, Nowak RM, et al. Breating Not Properly Multonational Study Investigators. Rapid measurement of B type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med 2002; 347: 161-7.
6.
Mueller C, Scholer A, Laule-Kilian K, et al. Use of B type natriuretic peptide in the evaluation and management of acute dyspnea. N Engl J Med 2004; 350: 647-54.
7.
McCullough PA, Duc P, Omland T, et al. Breating Not Properly Multonational Study Investigators. B type natriuretic peptide and renal function in the diagnosis of heart failure – an analysis from breathing not properly (BNP) multinational study. Am J Kidney Dis 2003; 41: 571-9.
8.
Moe GW, Howlett J, Januzzi JL, et al. N-terminal pro-BNP-type natriuretic peptide testing improves the management of patients with suspected acute heart failure: primary results of the Canadian prospective randomized multicenter IMPROVE-CHF study. Circulation 2007; 115: 3103-10.
9.
Mueller C, Laule-Kilian K, Schinaler C, et al. Cost-effectiveness of B-type natriuretic peptide testing in patients with acute dyspnea. Arch Inter Med 2006; 166: 1081-7.
10.
Pagel PS, Khel F, Gare M, et al. Mechanical function of the left atrium: new insights based on analysis of pressure-volume relations and Doppler echocardiography. Anestesiology 2003; 98: 975-94.
11.
Matsuda Y, Toma Y, Ogawa H, et al. Importance of left atrial function in patients with myocardial infarction. Circulation 1983; 67: 556-71.
12.
Thomas L, Levett K, Boyd A, et al. Compensatory changes in atrial volumes with normal aging: is atrial enlargement inevitable ? J Am Coll Cardiol 2002; 40: 1630-5.
13.
Hoit BD, Shao Y, Gabel M, et al. Left atrial systolic and diastolic function accompanying chronic rapid pacing-inducted atrial failure. Am J Physiol 1998; 275: H183-9.
14.
Pritchett AM, Jacobson SJ, Mahoney DW, et al. Left atrial volume as an index of left atrial size: a population based study. J Am Coll Cardiol 2003; 41: 1036-43.
15.
Lang RM, Bierig M, Devereux RB, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s guidelines and standards committee and the chamber quantification writing group, developed in conjunction with the European Society of Cardiology. J Am Soc Echocardiogr 2005; 18: 1440-63.
16.
Zapolski T, Wysokiński A. Atrial cardiomyopathy as a consequence of atrial fibrillation. Acta Cardiol 2002; 57: 84-6.
17.
Stahrenberg R, Edelmann F, Haase B, et al. Transthoracic echocardiography to rule out paroxysmal atrial fibrillation as a cause of stroke or transient ischemic attack. Stroke 2011; 42: 3643-5.
18.
Fatema K, Bailey KR, Petty GW, et al. Increased left atrial volume index: potent biomarker for first-ever ischemic stroke. Mayo Clin Proc 2008; 83: 1107-14.
19.
Tsang TS, Barnes ME, Gersh BJ, et al. Prediction of risk for first age-related cardiovascular events in an elderly population: the incremental value of echocardiography. J Am Coll Cardiol 2003; 42: 1199-205.
20.
Møller JE, Hillis GS, Oh JK, et al. Left atrial volume. A powerful predictor of survival after acute myocardial infarction. Circulation 2003; 107: 2207-12.
21.
Takemoto Y, Barnes ME, Seward JB, et al. Usefulness of left atrial volume in predicting first congestive heart failure in patients >= 65 years of age with well-preserved left ventricular systolic function. Am J Cardiol 2005; 96: 832-6.
22.
Gottdiener JS, Kitzman DW, Aurigemma GP, et al. Left atrial volume, geometry, and function in systolic and diastolic heart failure of persons >= 65 years of age (the Cardiovascular Health Study). Am J Cardiol 2006; 97: 83-9.
23.
Zapolski T, Jaroszyński A, Drelich-Zbroja A, et al. Czynność lewego przedsionka u chorych ze schyłkową niewydolnością nerek bez klinicznie jawnej choroby serca. Prognostyczna wartość wskaźnika objętości lewego przedsionka. Kardiol Pol 2010; 68 (Suppl. III): 277.
25.
Maisel A, Hollander JE, Guss D, et al. Primary results of the rapid emergency department heart failure outpatient trial (REDHOT): a multicenter study of B-type natriuretic peptide levels, emergency department decision making, and outcomes in patients presenting with shortness of breath. J Am Coll Cardiol 2004; 6: 1328-33.
26.
Troughton RW, Prior DL, Pereira JJ, et al. Plasma B-type natriuretic peptide levels in systolic heart failure: importance of left ventricular diastolic function and right ventricular systolic function. J Am Coll Cardiol 2004; 3: 416-22.
27.
Troughton RW, Richards AM. B-type natriuretic peptides and echocardiographic measures of cardiac structure and function. JACC Cardiovasc Imaging 2009; 2: 216-25.
28.
Cohen-Solal A, Logeart D, Huang B, et al. Lowered B-type natriuretic peptide in response to levosimendan or dobutamine treatment is associated with improved survival in patients with severe acutely decompensated heart failure. J Am Coll Cardiol 2009; 25: 2343-8.
29.
Kafkas N, Patsilinakos S, Makris K, et al. Brain natriuretic peptide: a marker of cardiac dysfunction with ventricular or dual-chamber pacing. Acta Cardiol 2011; 66: 589-94.
30.
Sadowski M, Wożakowska-Kapłon B. The influence of permanent cardiac pacing on plasma levels of B-type natriuretic peptide in patients with sick sinus syndrome. Cardiology J 2008; 15: 39-42.
31.
Wang R, Li X, Jiang W, et al. Observation of blood B-type natriuretic peptide level changes in different periods and different cardiac pacing modes. Chin Med J 2005; 118: 1384-7.
32.
Banjamin EJ, D´Agostino RB, Belanger AJ, et al. Left atrial size and the risc of stroke and death. The Framingham Heart Study. Circulation 1995; 92: 835-41.
33.
Møller JE, Hillis C, Oh JK, et al. Left atrial volume. A powerful predictor of survival after acute myocardial infarction. Circulation 2003; 107: 2207-12.
34.
Beinart R, Boyko V, Schwammenthal K, et al. Long-term prognostic significance of left atrial volume in acute myocardial infarction. J Am Coll Cardiol 2004; 44: 327-34.
35.
Kubica J, Stolarczyk L, Krzymińska E, et al. Left atrial size and wall motion in patients with permanent ventricular and atrial pacing. Pacing Clin Electrophysiol 1990; 13: 1737-41.
36.
Nielsen JC, Kristensen L, Andersen HR, et al. A randomised comparision of atrial and dual-chamber pacing in 177 consecutive patients with sick sinus syndrome: echocardiographic and clinical outcome. J Am Coll Cardiol 2003; 42: 614-23.
37.
Psychiari SN, Apostolou TS, Iiiodromitis EK, et al. DDDR pacing results in left ventricular asynchrony with preservation of ejection fraction and NT-proBNP: a prospectove study in sick sinus syndrome and normal ventricular function. Int J Cardiol 2010; 8: 310-2.
38.
Dencker M, Stagmo M, Dorkhan M. Relationship between natriuretic peptides and echocardiography parameters in patients with poorly regulated type 2 diabetes. Vasc Health Risc Manag 2010; 6: 373-82.
39.
Takeichi N, Fukada N, Tamura Y, et al. Relationship between left atrial function and plasma level of atrial natriuretic peptide in patients with heart disease. Cardiology 1998; 90: 13-9.
40.
Koç M, Bozkurt A, Şahin D, et al. Cutoff values of Nt proBNP for the prediction of low functional capacity, decreased ejection fraction and cardiovascular event in patients with heart failure. Cardiol J 2009; 16: 43-51.
Share
RELATED ARTICLE
| eISSN: | 2300-6722 |
| ISSN: | 1899-1874 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
