Tissue doppler imaging and plasma BNP levels to assess the prognosis in patients with hypertrophic cardiomyopathy.

摘要

BACKGROUND: In addition to sudden death, heart failure and stroke due to atrial fibrillation are important in patients with hypertrophic cardiomyopathy (HCM). The aim of the present study was to determine whether Doppler tissue imaging findings and plasma B-type natriuretic peptide (BNP) levels, which are widely used for risk stratification in several cardiovascular diseases, are useful for risk stratification in patients with HCM in a regional cohort. METHODS: One hundred thirty patients (82 men; mean age, 60 +/- 16 years) with HCM were enrolled in this study. RESULTS: Twenty end points were observed during a mean follow-up period of 3.7 +/- 1.7 years. Septal E/e' ratios and BNP levels in patients with events were higher than those in patients without events (17.4 +/- 6.3 vs 10.6 +/- 4.3, P < .0001, and 441 +/- 304 vs 202 +/- 174 pg/mL, P < .0001, respectively). By multivariate logistic regression analysis, a high septal E/e' ratio, in addition to a history of syncope and documentation of atrial fibrillation, was a significant predictor of combined end points. In contrast, plasma BNP levels were not a significant predictor of combined end points. CONCLUSION: Assessment by Doppler tissue imaging is useful for further risk stratification of patients with HCM.