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J Card Fail. 2009 Feb;15(1):41-7. doi: 10.1016/j.cardfail.2008.09.003. Epub 2008 Dec 2.

B-type natriuretic peptide and impedance cardiography at the time of routine echocardiography predict subsequent heart failure events.

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  • 1Division of Cardiology, Department of Medicine Veteran's Affairs San Diego Healthcare System, La Jolla, CA 92161, USA.

Abstract

BACKGROUND:

Detection of heart failure (HF) in stable outpatients can be difficult until an overt event occurs. This study sought to determine whether the combination of B-type natriuretic peptide (BNP) and impedance cardiography (ICG) could be used in a nonacute clinical setting to risk stratify and predict HF-related events in stable outpatients.

METHODS AND RESULTS:

Patients undergoing routine outpatient echocardiography underwent ICG and BNP testing and were followed for one year for HF-related events (Emergency Department [ED] visit or hospitalization due to HF or all-cause death). A total of 524 patients were analyzed, resulting in 57 HF-related events; 16 ED visits, 17 hospitalizations, and 24 all-cause deaths. Using Cox regression analyses, BNP and systolic time ratio index (STRI) by ICG proved to be the strongest predictors of future HF-related events. Patients with a BNP >100 pg/ml and STRI >0.45 sec(-1) had a significantly lower event-free survival rate than those with a high BNP and low STRI (67% versus 89%, P=.001). In patients with LV dysfunction only, if both BNP and STRI values were high, the relative risk of a HF-related event increased by 12.5 (95 % C.I. 4.2-36.7), when compared with patients with a low BNP and low STRI (P<.001).

CONCLUSIONS:

In a nonacute clinical setting, both BNP and ICG testing can provide unique predictive power of long-term HF-related events in a stable cohort of patients with and without LV dysfunction.

PMID:
19181293
[PubMed - indexed for MEDLINE]
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