Relationship Between Isovolumic Acceleration (IVA) and TEI Index with Pro-BNP in Heart Failure

Background: Heart failure (HF) is a common disorder and leads to many costs for the healthcare system. Brain natriuretic peptide (BNP) is a cardiac neurohormone and has an important function in diagnosis and prognosis of left ventricular (LV) dysfunction. The TEI index is a novel non-invasive Doppler-based indicator, which evaluates systolic and diastolic myocardial function. There are few data regarding the prognostic role of TEI and isovolumic acceleration (IVA) indexes in HF and the relationship with neurohormonal activation. In this study, we evaluated the TEI and IVA index correlation with Pro-BNP in patients with systolic HF. Patients and Methods: This was a cross-sectional study. We included consecutively patients with HF, admitted to Imam Reza Hospital, Mashhad, Iran between March 2017 and February 2019. A single investigator would perform echocardiography the next morning, for all patients. A checklist was completed for each patient and included demographic data, clinical data and different echocardiographic variables. We also recorded in-hospital mortality and outcome of patients during the follow-up stage. Results: We finally included 65 patients according to inclusion and exclusion criteria. The mean age of participants was 63.38± 12.85 years. Most of them were male (61.5%). We showed that there is a direct and significant relationship between RVIVA (r=0.317, P =0.010) and LVIVA (r=0.254, P =0.041) with LVEF. There was no significant correlation between Pro-BNP level and NYHA classification (r=0.151, P =0.231). We showed that there was no correlation between Pro-BNP level and RV TEI index (r=0.065, P =0.490) and LV TEI index (r=0.071, P =0.419). In sub-group analysis, in patients with EF< 20%, we showed a significant correlation between the level of Pro-BNP and RV TEI index. Conclusion: We showed that the IVA index is correlated to EF in both RV and LV and can differ in large-scale in a population study. We also showed that RV TEI index is significantly correlated with Pro-BNP in patients with EF< 20%. Large-scale studies are recommended.