Key result
Left ventricular diastolic filling patterns improved during acute heart failure therapy, with patients achieving an abnormal relaxation pattern having significantly lower discharge NT-proBNP levels than those with a pseudonormal pattern (1440 vs 1958 pg/mL, p=0.003).
Why the study?
It was investigated whether Doppler transmitral flow parameters on admission and discharge offer a useful guide like NT-proBNP levels in acute heart failure.
Does the left ventricular diastolic filling pattern offer a useful guide similar to NT-proBNP levels in patients with acute heart failure?
Observational (n=57)
No
Does the left ventricular diastolic filling pattern offer a useful guide similar to NT-proBNP levels in patients with acute heart failure?
Left ventricular diastolic filling patterns assessed by echocardiography correlate with NT-proBNP levels and may serve as a useful guide for therapy in acute heart failure.
Answers are grounded in this paper and cite their sources.
Transmitral Doppler may support decongestion monitoring in acute HF; leaves open equivalence to NT-proBNP guidance in larger trials.
Aim: N-terminal pro B-type natriuretic peptide has been commonly used in acute heart failure. We investigated whether the Doppler transmitral flow parameters on admission and discharge offer a useful guide like N-terminal pro B-type natriuretic peptide levels in acute heart failure. Material and Method: This study with a prospective randomized design included 57 patients admitted to the emergency department between October 2019 and March 2020. All patients had New York Heart Association class IV, had sinus rhythm, and were diagnosed previously with dilate cardiomyopathy. The left ventricular diastolic filling pattern during admission and discharge was evaluated in all patients using transthoracic echocardiography. N-terminal pro B-type natriuretic peptide levels were analyzed on admission and discharge to compare the left ventricular filling pattern. Results: The average age of the patients was 64.94±5.56 years. During admission, the left ventricular filling pattern of all patients was of restrictive type (type III), whereas during discharge, 46 patients had abnormal relaxation (type I) and 11 patients had pseudonormal (type II) filling pattern. N-terminal pro B-type natriuretic peptide levels were 8004.75±743 pg/mL and 1645.17±104.58 pg/mL during admission and discharge, respectively. The mean e/e’ ratio of the patients was 14.83±0.25 and 7.70±0.14 and E/A ratio was 2.51±0.35 and 1.42±0.33 during admission and discharge, respectively. N-terminal pro B-type natriuretic peptide levels with regard to the mitral filling pattern were different during discharge. The N-terminal pro B-type natriuretic peptide level with an abnormal relaxation pattern was 1440.43±144.75 pg/mL and that with a pseudonormal pattern was 1957.60±64.00 pg/mL (p=0.003). Conclusion: Our study demonstrated that the left ventricular filling pattern successfully guided in acute heart failure therapy, similar to N-terminal pro B-type natriuretic peptide -guided therapy.
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Sarıçam et al. (2020) conducted an observational in Acute heart failure (n=57). Left ventricular diastolic filling pattern was evaluated on NT-proBNP levels at discharge according to mitral filling pattern (p=0.003). Left ventricular diastolic filling patterns improved during acute heart failure therapy, with patients achieving an abnormal relaxation pattern having significantly lower discharge NT-proBNP levels than those with a pseudonormal pattern (1440 vs 1958 pg/mL, p=0.003).
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