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ȣ - 490375 78 |
| Changes of plasma NT-proBNP level can predict changes of echocardiographic variables after medical treatment in hypertrophic cardiomyopathy with normal ejection fraction |
| Department of Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center |
| Seon Woon Kim, Hak Jin Kim, Wang-Soo Lee, Jae Hyuck Choi, Sung Uk Kwon, Yu Jeong Choi, Jin-Ho Choi, Sang-Chol Lee, Seung Woo Park, Duk-Kyung Kim, Sang Hoon Lee, Jeong Euy Park, Eun-Seok Jeon |
Background: N-Terminal Pro-B type Natriuretic Peptide (NT-proBNP) is increased in the plasma of the patients with hypertrophic cardiomyopathy (HCM). However, the relationships of the changes of plasma NT-proBNP level and echocardiographic variables have not been reported in HCM patients after medical treatment. This study was aimed whether the plasma NT-proBNP levels and echocardiographic variables change after medical treatment and to find the correlations between two clinical parameters in HCM with normal ejection fraction (LVEF>55%). Methods: We measured plasma NT-proBNP levels and echocardiographic variables in 59 patients (M:F=49:10, 55±12 years) with HCM before and after medical treatment. Mean plasma NT pro-BNP level and echocardiography follow up interval was 12±4 and 20±11 months respectively. The measured echocardiographic variables were LV wall thickness, LVEF, LV end-diastolic dimension (LVEDD) and volume (LVEDV), LA volume, LA volume index (LA volume/ body surface area, BSA), LV mass, LV mass index (LV mass/BSA). And using Doppler echocardiographic technique, LV outflow tract (LVOT) peak pressure gradient, transmitral E and A velocities, deceleration time (DT) and septal anular E’ velocity, transmitral peak E velocity/septal anular E’ velocity (E/E’) were also measured. Results: Plasma NT-proBNP level (p=0.037), DT (p=0.048), LA volume index (p=0.001), E/E’ (p=0.022), LV mass index (p=0.005) and LVOT peak pressure gradient (p=0.008) were significantly decreased after medical treatment. Changes of LA volume index (r=0.778, p=0.023) and LVOT peak pressure gradient (r=0.999, p=0.001) during follow up period were excellently correlated with degree of the change of plasma NT-proBNP level. In multivariable analysis, degree of the change of NT-proBNP level was independently related to the LVOT peak pressure gradient (p=0.001). Conclusion: Elevated plasma NT-proBNP levels decreased after medical treatment in patients with HCM even in normal systolic function, and the changes of plasma NT-ProBNP levels were correlated with degree of LVOT obstruction. These data demonstrated that serial NT-proBNP levels could be used in monitoring LV hemodynamic changes in patients with HCM during medical treatment.
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