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Associations of tissue Doppler imaging with NT-proBNP and hs-TnT: a pilot study
in end-stage renal disease
#MMPMID24828699
Dubin RF
; Beatty AL
; Teerlink JR
; Schiller NB
; Alokozai D
; Johansen KL
Echocardiography
2014[Nov]; 31
(10
): 1205-12
PMID24828699
show ga
BACKGROUND: Diastolic dysfunction is common and associated with higher mortality
in the end-stage renal disease (ESRD) population. E/E', a measure derived from
tissue Doppler imaging (TDI), is a correlate of left ventricular (LV) filling
pressures. E/E' may be viewed as a confirmatory marker of diastolic dysfunction,
but it is not routinely used to quantify diastolic dysfunction. Whether E/E' is
associated with N-terminal brain natriuretic peptide (NT-proBNP) or high
sensitivity troponin T (hs-TnT) in this population is not known. METHODS: We
performed echocardiograms and serology prior to the 2nd or 3rd dialysis session
of the week on 35 chronic hemodialysis patients. We compared TDI parameters (E/E'
and E' alone), traditional categories of diastolic function (normal, impaired,
pseudonormal or restrictive), and ejection fraction (EF) as potential predictors
of the outcomes NT-proBNP and hs-TnT. RESULTS: Higher E/E' was associated with
higher NT-proBNP (rho 0.48, P = 0.004) and hs-TnT (rho 0.37, P = 0.03). EF did
not have statistically significant associations with NT-proBNP (rho -0.2, P =
0.4) or hs-TnT (rho -0.24, P = 0.16). As compared to patients with normal
diastolic function, those with impaired or pseudonormal filling patterns did not
have significantly different levels of NT-proBNP (P = 0.46); patients in
traditional categories of worsened diastolic function actually had lower hs-TnT
(P = 0.02). The associations of E/E' with higher NT-proBNP and hs-TnT persisted
after multivariate adjustment for EF, LV mass, and volume status. CONCLUSIONS:
Tissue Doppler imaging may be more useful in evaluating cardiac function than
traditional measures of diastolic dysfunction in the ESRD population.
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