N-terminal proatrial natriuretic peptide correlates with systolic dysfunction and left ventricular filling pattern in patients with idiopathic dilated cardiomyopathy

Objective-To investigate the diastolic Doppler filling pattern in patients with idiopathic dilated cardiomyopathy and its relation to N-terminal pro-a trial natriuretic peptide (NT-pro-ANP). Methods-32 patients (26 male, six female) with idiopathic dilated cardiomyo pathy were investigated. All were in sinus rhythm. Conventional M mode echo cardiography and Doppler echocardiography was done in each patient. Pulsed wave Doppler inflow signals were obtained and the following variables were measured: maximum E wave, maximum A wave, EIA ratio, E wave deceleration ti me, A wave deceleration time. NT-pro-ANP was measured using radioimmunoassa y. Results-Mean (SD) left ventricular ejection fraction was 34 (7)% and mean l eft ventricular end diastolic diameter on M mode echocardiography was 69 (7 ) mm. Left ventricular filling indices were as follows: maximum E wave velo city, 0.86 (0.22) m/s; maximum A wave velocity, 0.71 (0.24) m/s; E/A ratio, 1.41 (0.65). Mean E wave deceleration time was 140 (50) ms; mean A wave de celeration time was 100 (20) ms. In a stepwise forward regression model, NT -pro-ANP correlated significantly with left atrial diameter (r = 0.603; p < 0.001), left ventricular ejection fraction (r = -0.758; p < 0.001), and Do ppler derived EIA ratio (r = 0.740; p < 0.001). Conclusions-In patients with idiopathic dilated cardiomyopathy there is a r elation between NT-pro-ANP and both systolic and diastolic variables. In a multivariate model NT-pro-ANP correlated with left atrial diameter, left ve ntricular ejection fraction, and Doppler derived EIA ratio on transmitral i nflow.