The extent of myocardial damage assessed by contrast-enhanced MRI is a major determinant of N-BNP concentration after myocardial infarction

doi:10.1016/j.ejheart.2003.11.012

European Journal of Heart Failure 2004 6(5):555-560; doi:10.1016/j.ejheart.2003.11.012

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The extent of myocardial damage assessed by contrast-enhanced MRI is a major determinant of N-BNP concentration after myocardial infarction

Alexandre Cochet^a, Marianne Zeller^b, Yves Cottin^b^,*, Clothilde Robert-Valla^a, Alain Lalande^a, Isabelle L'Huilllier^b, Alexandre Comte^a, Paul M. Walker^a, Jean Desgres^c, Jean-Eric Wolf^b and François Brunotte^a

^a Unité d'IRM, CHU Hopital d'enfants, Bd Mal de Lattre de Tassigny 21034 Dijon Cedex, France
^b Service de Cardiologie, CHU Bocage, 2, Bd Mal de Lattre de Tassigny 21034 Dijon Cedex, France
^c Laboratoire de Biochimie, CHU Hopital d'enfants, Bd Mal de Lattre de Tassigny 21034 Dijon Cedex, France

^* Corresponding author. Tel.: +33-3-80-29-33-11; Fax: +33-3-80-29-33-33. E-mail address: yves.cottin{at}chu-dijon.fr

Abstract

Aims: To evaluate the relationship between N-terminal Pro-Brain NatriureticPeptide (N-BNP) level and contrast-enhanced MRI in patientsafter acute myocardial infarction (MI).

Methods: Eighty-two patients were studied. Venous blood samples wereobtained 3 days after MI and MRI was performed from 2 to 7 daysafter MI, with determination of left ventricular function andacquisition of perfusion data after injection of gadolinium-DTPA.First-pass images (FPI) and Delayed contrast-enhanced (CE) imageswere analyzed using a 17-segment model, and the extent of transmuralitywas determined by a visual score.

Results: Univariate analysis showed that age (P<0.001), sex (P<0.02),Left Ventricular Ejection Fraction (LVEF) <45% (P<0.002),creatinine (P<0.05) and delayed CE-MR images (P<0.006)were predictors of a supramedian N-BNP level. FPI was not apredictor in this univariate analysis (P<0.078). In a multivariatemodel, only age, LVEF <45% and delayed CE-MRI were associatedwith an increased N-BNP level.

Conclusion: After MI, high N-BNP levels are dependent on the LVEF but alsoon the myocardial infarct size derived from the delayed CE-MRimages.

Key Words: Brain natriuretic peptide • Myocardial infarction • Magnetic resonance imaging (MRI) • Delayed CE-MRI

Received May 7, 2003; Revised October 16, 2003; Accepted November 30, 2003

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