Copyright © 2004 by the European Society of Cardiology.
Clinical research
N-terminal proatrial natriuretic peptide predicts two-year remodelling in patients with acute transmural myocardial infarction
a Section of Cardiology, Medical Department, Ålesund Hospital, N-6026, Ålesund, Norway
b Research Institute for Internal Medicine, University of Oslo, Norway
c Cardiology Department, St. Olav Hospital, University Hospital Trondheim, Norway
* Corresponding author. Tel.: +47-70-10-50-00/14-91-85; fax: +47-70-15-19-45/15-39-41
E-mail address: torstein.hole{at}helse-sunnmore.no
E-mail address: torstein.hole{at}adsl.no
Received 13 May 2003; revised 1 October 2003; accepted 16 October 2003
Abstract
Aims To evaluate whether baseline N-terminal proatrial natriuretic peptide (Nt-proANP) or Doppler echocardiographic parameters could predict two-year left ventricular remodelling after acute myocardial infarction in patients without heart failure.
Methods and results Seventy-one patients were followed with Doppler echocardiographic examinations at baseline, 3 months, 1 and 2 years, and Nt-proANP was measured at baseline and 3 months. After 2 years there was a significant increase in end-diastolic volume index of 11% (
) and end-systolic volume index of 14% (
), and no change in ejection fraction. This remodelling was confined to 12 patients (17%) with a significant increase in end-diastolic volume index above 20 ml/m2. Baseline Nt-proANP (
), 3-month changes in end-diastolic volume index (
), and 3-month E/A ratio (
) were independent positive predictors for two-year changes in end-diastolic volume index. Two-year dilatation above 20 ml/m2 was predicted by baseline Nt-proANP () and maximal velocity of systolic pulmonary venous flow (
).
Conclusion Seventeen percent of patients with transmural myocardial infarction and no baseline heart failure experienced a significant left ventricular dilatation at 2 years, and this was best predicted by baseline Nt-proANP.Unstructured abstract
Seventy-one patients with acute myocardial infarction and no heart failure were followed for two years in an observational Doppler echocardiographic study. There was a significant increase in end-diastolic volume index of 11% () and end-systolic volume index of 14% (), but no change in ejection fraction after two years. Nt-proANP was the strongest independent predictor of two-year changes in end-diastolic volume index and of an increase in end-diastolic volume index above 20 ml/m2 after two years.
Key Words: Diastolic function • Systolic function • Left ventricular remodelling • Acute myocardial infarction • ProANP
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