P321Nt-ProBNP and ventricular global function in pulmonary hypertension. 2D-Strain study.


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Abstract

Introduction: Nt-ProBNP is an important prognostic marker in heart failure patientsObjective: Assess Nt-ProBNP relationship with right (RV) and left (LV) ventricles global function evaluated by TDI and 2D-strain parameters.Methods: 20 patients, age 65.4 ±13.5, with PAH on specific therapy, median Nt-ProBNP 730, TAPSE 21.0 ±5.7, RV ejection fraction 36.7±18.4%, pulmonary artery pressure (PAP) 85.9±15mmHg. RV and LV longitudinal global strain (GS), tricuspid annulus TDI S wave, Mitral S and A wave and TAPSE evaluated. Relationship between parameters evaluated with Spearman correlation coefficient and linear regression model (backward method). Nt-ProBNP was grouped accordingly to the tertiles (730.0 and 1029.0pg/ml).Results: (1) Nt-ProBNP correlated with: (i) RV function: TAPSE (r= -0.583 p=0.007), TrS (r=-0.539 p=0.017), RV-GS (r=0.563 p=0.010), RV-GSRs (r=0.485 p=0.03) and RV-GSRa (r=-0.654 p=0.006). (ii) LV function: Mt-A (r=-0.599 p=0.031), LS-GS (r= 0.585 p=0.008) and LV-GSRa (r=0.565 p=0.022). By multiregression the independent predictors of Nt-ProBNP were TAPSE (p=0.08), TrS (p=0.017), RV-GSRa (p=0.019) and LV-GSRa (p=0.027). (2) Greater Nt-ProBNP tertiles (see table) greater the LV and RV dysfunction.Conclusion: In pulmonary hypertension Nt-ProBNP is associated with systolic and diastolic parameters; however it's mainly dependent on RV and LV longitudinal strain markers of diastolic dysfunction.

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