Purpose:
Right ventricular (RV) dysfunction is an important cause of mortality in patients with pulmonary hypertension (PH) and elevated serum level of brain natriuretic peptide (BNP) is also associated with poor prognosis in those patients. We evaluated relationship of RV diastolic function calculated by pulsed tissue doppler imaging (TDI) with BNP in patients with PH using multiple regression analysis.
Materials and methods:
In consecutive 91 patients with pulmonary hypertension (64 with chronic pulmonary thromboembolis (CPTE), 13 with primary PH and 13 with PH due to collagen disease), systolic wave (Sw) early diastolic wave(Ew) atrial wave (Aw) at tricuspid annulus and early (E) and atrial (A) RV inflow waves were obtained from 4-chamber view and E/Ew of RV was calculated as the parameter of RV diastolic function using TDI (Aplio 80 SSA-770A, Toshiba, Japan). BNP and other echo parameters including estimated pulmonary arterial systolic pressure (PASP) and cardiac output (CO) were also obtained.
Result:
In all subjects, elevated PASP (mean 64±33 mmHg) and BNP (mean 161±198 pq/dl) could be observed. BNP was positively correlated with E/Ew of RV, Aw and PASP(r=0.43, 0.24, and r=0.24, respectively all p<0.01). Next all predictor variables were used in a multiple regression model with serum BNP values as dependent variables, which was refined to include 2 predictors: E/Ew of RV, and PASP. And here, E/Ew of RV and PASP significantly influenced the serum BNP value (p<0.01) by the multiple regression formula Y =22.9X1** + 2.12X2 ** ** P values<0.01. Y=BNP level, X1=E/Ew of RV, X2=PASP (standard regression coefficients were 0.43 and 0.31, respectively)
Conclusion:
BNP were significantly correlated with RV diastolic dysfunction obtained by TDI in subjects with PH and increment of BNP may have relationship of decrement of RV diastolic function in those subjects.
Evaluation of cardiac functions of cirrhotic children using serum brain natriuretic peptide and tissue Doppler imaging
