The role of echocardiography and its comparison with NT-proBNP measurements in patients with acute myocardial infarction
Naresh Ranjith, Rosemary J. Pegoraro, Datshana P. Naidoo, Amelia S. Kaloo, Tonya M. Esterhuizen
Med Sci Monit 2007; 13(12): CR574-578
This study investigated the use of echocardiography in the early detection of regional wall motion abnormalities (RWMA) in patients presenting with acute myocardial infarction (AMI). The relationship between RWMA and mechanical complications, as assessed by two-dimensional echocardiography, and admission levels of amino terminal fragment of pro-brain natriuretic peptide (NT- proBNP) was also examined.
Material and Method: The study population comprised 226 patients admitted to hospital with a diagnosis of AMI. Echocardiography and NT-proBNP measurements were performed on all patients.
Results: Sixty-eight percent of the patients with AMI were found to have RWMA on echocardiography. Significantly more patients had RWMA within any given range of ejection fraction (EF) (p<0.001), but this difference was most pronounced in those with left ventricular (LV) dysfunction. Mitral regurgitation was the most common complication (48%) seen on echocardiography. The majority of patients (84%) had elevated NT-proBNP levels on admission; this was evident in all categories of EF (p=0.003). In those with normal EF on echocardiography (58%), more patients had elevated levels regardless of the presence of RWMA.
Conclusions: This study showed that echocardiography is useful in the detection of RWMA in the early stages of AMI. No significant relationship was demonstrated between NT-proBNP levels and RWMA in patients with normal or abnormal LV function. Admission plasma NT-proBNP may, however, be considered as an additional marker in the diagnosis of AMI, especially in those without RWMA.
Keywords: Peptide Fragments - blood, Natriuretic Peptide, Brain - blood, Myocardial Infarction - ultrasonography, Mitral Valve Insufficiency - ultrasonography, Middle Aged, Male, Humans, Female, Ventricular Dysfunction, Left - physiopathology, Biological Markers - metabolism, Aged, Acute Disease