Left ventricular end diastolic pressure and serum brain natriuretic peptide levels in patients with abnormal impedance cardiography parameters.

摘要

BACKGROUND: Distinct hemodynamic patterns determined by impedance cardiography (ICG) have been found to be superior to clinical assessment for the identification of patients at risk for heart failure decompensation in the outpatient setting. Correlation of these hemodynamic patterns with serum brain natriuretic peptides (BNP) and left ventricular end diastolic pressure (LVEDP) has not been established. We evaluated the correlation of low-, intermediate- and high-risk groups for acute decompensation of heart failure (ADHF) as determined by ICG parameters with LVEDP and serum BNP. METHODS: Consecutive patients referred for cardiac catheterization with echocardiographic diagnosis of left ventricle dysfunction (systolic or diastolic) or history of congestive heart failure (CHF) underwent ICG evaluation, serum BNP measurement, and LVEDP by cardiac catheterization. Three groups at different levels of risk for ADHF were determined according to ICG parameters: thoracic fluid content (TFC) and stroke volume index (SVI); low risk (low TFC, high SVI), intermediate risk (low-low or high-high TFC and SVI, respectively), and high risk (high TFC and low SVI). RESULTS: Sixty three patients were included in the present study. Mean LVEDP and serum BNP levels were 20.2 +/- 8.2 mmHg and 814 +/- 1005 pg/mL, respectively, in the high-risk group in comparison to 12.3 +/- 6.2 mmHg and 53 +/- 38 pg/mL in the low-risk group (p = 0.01 and p = 0.009). CONCLUSIONS: Patients with ICG parameters that represent high risk for ADHF have higher levels of serum BNP and LVEDP in comparison with patients who have intermediate- or low-risk ICG parameters for ADHF.