What question did this study set out to answer?

To compare the diagnostic utility of multiple neurohumoral plasma markers for evaluating left ventricular dimensions and ejection fraction in patients with systolic heart failure.

December 1, 2001European Journal of Heart FailureOpen Access

Evaluation of Impaired Left Ventricular Ejection Fraction and Increased Dimensions by Multiple Neurohumoral Plasma Concentrations

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Why the study?

Which neurohumoral marker has the greatest diagnostic potential for assessing left ventricular dimensions and ejection fraction in patients with systolic heart failure?

Key Points

To compare the diagnostic utility of multiple neurohumoral plasma markers for evaluating left ventricular dimensions and ejection fraction in patients with systolic heart failure.
Evaluated 48 patients with symptomatic systolic heart failure alongside 20 age- and gender-matched normal controls (N=68).
Measured plasma levels of epinephrine, norepinephrine, renin activity, aldosterone, atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), arginine-vasopressin, and endothelin alongside cardiac magnetic resonance imaging.
BNP emerged as the strongest independent marker for left ventricular end-diastolic volume (r=0.71, P<0.0001), end-systolic volume (r=0.75, P<0.0001), myocardial mass (r=0.69, P<0.0001), and ejection fraction (r=-0.78, P<0.0001).
Multivariate regression revealed incremental diagnostic value when adding ANP for end-diastolic (r=0.76, P<0.0001) and end-systolic volumes (r=0.78, P<0.0001), endothelin for myocardial mass (r=0.71, P<0.0001), and aldosterone for ejection fraction (r=-0.81, P<0.0001).

Structured PICO

Which neurohumoral marker has the greatest diagnostic potential for assessing left ventricular dimensions and ejection fraction in patients with systolic heart failure?

Population

68 individuals (48 patients with symptomatic systolic heart failure and 20 age and gender-matched normal controls)

Intervention

Measurement of multiple neurohumoral plasma concentrations (epinephrine, norepinephrine, renin activity, aldosterone, ANP, BNP, arginine-vasopressin, endothelin)

Outcome

Correlation of neurohumoral markers with left ventricular dimensions (end-diastolic and end-systolic volumes, myocardial mass) and ejection fraction (LVEF) measured by magnetic resonance imagingsurrogate

BNP is the strongest single neurohumoral marker for assessing left ventricular dimensions and ejection fraction in systolic heart failure, though a comprehensive panel may provide supplementary information.

Discussion

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Implication

BNP may complement noninvasive LV assessment in systolic HF; leaves open whether panels add meaningful clinical value beyond imaging.

Cite This Study

Groenning et al. (2001) studied this question.

synapsesocial.com/papers/6a79f3e1fb5b6b43000ddc0f https://doi.org/10.1016/s1388-9842(01)00181-7

Topics

HFrEF treatment Heart failure

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Evaluation of Impaired Left Ventricular Ejection Fraction and Increased Dimensions by Multiple Neurohumoral Plasma Concentrations

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Evaluation of Impaired Left Ventricular Ejection Fraction and Increased Dimensions by Multiple Neurohumoral Plasma Concentrations

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider