Prognostic significance of tricuspid annular motion and plasma NT-proBNP in patients with heart failure and moderate-to-severe functional mitral regurgitation

doi:10.1016/j.ejheart.2008.04.003

European Journal of Heart Failure 2008 10(6):573-580; doi:10.1016/j.ejheart.2008.04.003

This Article

	Full Text
	FREE Full Text (PDF)
	Alert me when this article is cited
	Alert me if a correction is posted

Services

	Email this article to a friend
	Similar articles in this journal
	Similar articles in ISI Web of Science
	Similar articles in PubMed
	Alert me to new issues of the journal
	Add to My Personal Archive
	Download to citation manager
	Search for citing articles in: ISI Web of Science (1)
	Request Permissions
	Disclaimer

Google Scholar

	Articles by Dini, F. L.
	Articles by De Tommasi, S. M.
	Search for Related Content

PubMed

	PubMed Citation
	Articles by Dini, F. L.
	Articles by De Tommasi, S. M.

Social Bookmarking

	What's this?

Prognostic significance of tricuspid annular motion and plasma NT-proBNP in patients with heart failure and moderate-to-severe functional mitral regurgitation

Frank Lloyd Dini^a^,*, Paolo Fontanive^a, Erica Panicucci^a^,b, Diana Andreini^a, Piersilvio Chella^a and Salvatore Mario De Tommasi^a

^a Unità Malattie Cardiovascolari 2, Santa Chiara Hospital Pisa, Italy
^b Dipartimento di Patologia Sperimentale, Tecnologie Biomediche ed Epidemiologia, Università di Pisa Italy

^* Corresponding author. Unità Operativa Malattie Cardiovascolari 2, Ospedale S. Chiara, Azienda Ospedaliera-Universitaria Pisana, Via Roma, 67-56126, Pisa, Italy. Tel.: +39 050 992355; fax: +39 050 993114. E-mail address: f.dini{at}ao-pisa.toscana.it

Abstract

Background: The role of the right ventricle has been relatively neglectedproportionate to its importance. We sought to evaluate the impactof right ventricular (RV) and NT-proBNP on the outcome of patientswith heart failure (HF) and functional mitral regurgitation(MR).

Methods and patients: Outpatients with left ventricular (LV) systolic HF (ejectionfraction [EF] $≤$ 45%) and moderate-to-severe MR measured by a venacontracta width $≥$ 0.5 cm were prospectively enrolled (n=142).Indexes of LV and RV function, including tricuspid annular planesystolic excursion (TAPSE), RV fractional area change and tissueDoppler RV acceleration at isovolumic contraction and NT-proBNPplasma levels were measured at the time of the index echocardiogram.

Results: Multivariate predictors of all-cause mortality included TAPSE<16mm (hazards ratio [HR]: 2.64; p=0.009) and plasma NT-proBNP $≥$ 3283pg/ml (HR: 2.58; p=0.011). TAPSE<16mm and plasma NT-proBNP $≥$ 3283pg/ml added incremental prognostic information to LV EF $≤$ 25%,NYHA classes 3–4, coronary artery disease, elderly ageand male sex. The 36-month Kaplan–Meier curve showed thatsurvival was worst in the group with TAPSE<16 mm and NT-proBNP $≥$ 3283pg/ml (p<0.0001).

Conclusion: This study demonstrates the significance of TAPSE and plasmaNT-proBNP in predicting all-cause mortality in patients withsystolic HF and moderate-to-severe functional MR.

Key Words: Dilated cardiomyopathy • Natriuretic peptides • Functional mitral regurgitation • Right ventricular function • Prognosis

Received November 28, 2007; Revised February 11, 2008; Accepted April 7, 2008

Add to CiteULike CiteULike Add to Connotea Connotea Add to Del.icio.us Del.icio.us What's this?

This article has been cited by other articles:

A. Chrustowicz, G. Simonis, K. Matschke, R. H. Strasser, and A. Gackowski
Right ventricular dilatation predicts survival after mitral valve repair in patients with impaired left ventricular systolic function
Eur J Echocardiogr, March 1, 2009; 10(2): 309 - 313.
[Abstract] [Full Text] [PDF]