Abstract 14921: The Product of E/A and Log BNP is a Novel Parameter to Predict Left Ventricular Filling Pressure
Background: Increased mitral inflow early diastolic (E) velocity to tissue Doppler E’ ratio (E/E’) and elevated mitral E to late diastolic pattern ratio (E/A) are implicated as elevated left ventricular (LV) filling pressure. However, we often encounter some cases with low LV filling pressure, but increased E/E’ or E/A. Thus, we attempted to test a novel parameter by multiplying E/A and log BNP (BNPхE/A) for the prediction of LV filling pressure.
Methods: Two hundred and ten patients with ischemic heart disease or cardiomyopathy were analyzed in the study. Both right heart catheterization and echocardiography were performed in all patients.
Results: BNPхE/A showed the highest correlation coefficient with mean pulmonary capillary wedge pressure (mPCWP, r=0.689) compared to E/A and E/E’ (r=0.642 and r=0.329, respectively). BNPхE/A also showed the highest correlation coefficient with mean pulmonary artery pressure (mPAP, r=0.636) compared to E/A and E/E’ (r=0.589 and r=0.394, respevtively). Multivariate logistic regression analysis revealed that BNPхE/A was significantly associated with elevated mPCWP (≥18 mmHg, OR 1.699, 95%CI 1.298-2.353, P<0.01) and mPAP (≥25 mmHg, OR 1.889, 95%CI 1.412-2.681, P<0.01). In receiver operator characteristic curve analysis for detecting elevated mPCWP, BNPхE/A showed the largest area under the curve (AUC) compared to E/A and E/E’ (0.859 vs. 0.815 and 0.735, respectively, P<0.05, figure). To detect elevated mPCWP, BNPхE/A had sensitivity 0.857 and specificity 0.749, when cutoff value was set at 1.802. BNPхE/A also showed the largest AUC for detecting elevated mPAP compared to E/A and E/E’ (0.850 vs. 0.796 and 0.752, respectively, P<0.05). To detect elevated mPAP, BNPхE/A had sensitivity 0.838 and specificity 0.727, when cutoff value was set at 1.720.
Conclusion: We conclude that BNPхE/A is a useful parameter for detecting elevated LV filling pressure.
Author Disclosures: M. Oikawa: None. A. Kobayashi: None. K. Wada: None. T. Sato: None. S. Suzuki: None. A. Yoshihisa: None. K. Nakazato: None. S. Saitoh: None. Y. Takeishi: None.
- © 2016 by American Heart Association, Inc.