September 15, 2026Journal of the American College of Cardiology
Incremental predictive power of B-type natriuretic peptide and tissue Doppler echocardiography in the prognosis of patients with congestive heart failure
Key result
Elevated pre-discharge BNP and mitral E/Ea improve prediction of cardiac death or CHF readmission.
- P=0.02
- n=116
Why the study?
It was unknown how novel indexes of left ventricular filling pressure, specifically E/Ea and BNP, compare to conventional predictors of outcome in patients with congestive heart failure.
Population
116 consecutive patients hospitalized with CHF
Comparison
E/Ea and BNP vs conventional predictors of outcome
Design
Prospective observational cohort study
Follow-up
Mean of 527 days
Authors
Discussion
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Implication
May enhance HF risk stratification; extends single-marker data but remains hypothesis-generating pending prospective validation.
Key Points
- To assess whether combining circulating B-type natriuretic peptide levels with tissue Doppler echocardiography parameters provides incremental prognostic utility in patients with congestive heart failure.
- Evaluated circulating B-type natriuretic peptide (BNP) concentrations in patients presenting with congestive heart failure.
- Performed tissue Doppler echocardiography to quantify myocardial velocities and evaluate cardiac filling dynamics.
- Applied multivariable survival modeling to measure the added predictive value of combining biochemical and echocardiographic markers over individual assessments.
- Both elevated B-type natriuretic peptide concentrations and impaired tissue Doppler myocardial velocity indices demonstrate strong independent associations with adverse clinical outcomes.
- Incorporating tissue Doppler echocardiography parameters alongside plasma BNP levels yields superior prognostic discrimination compared with risk models relying on either biomarker alone.
Study Design
Type
Cohort (n=116)
PICO
P
Population
116 consecutive patients hospitalized with congestive heart failure, followed for a mean of 527 days after hospital discharge.
E
Exposure / Comparator
B-type natriuretic peptide (BNP) and tissue Doppler echocardiography (E/Ea) vs Conventional predictors
O
Primary Outcome
Cardiac death or re-hospitalization for CHF, p=0.02
Main Result
p-value: p=0.02
Cite This Study
Dokainish et al. (2005) conducted a cohort in congestive heart failure (CHF) (n=116). B-type natriuretic peptide (BNP) and tissue Doppler echocardiography (E/Ea) vs. Conventional predictors was evaluated on Cardiac death or re-hospitalization for CHF (p=0.02). Pre-discharge BNP ≥250 pg/ml and mitral E/Ea ≥15 provided incremental predictive power for cardiac death or CHF re-hospitalization over conventional predictors (p=0.02).