The extent of myocardial damage assessed by contrast-enhanced MRI is a major determinant of N-BNP concentration after myocardial infarction

Abstract : Abstract: Aims: To evaluate the relationship between N-terminal Pro-Brain Natriuretic Peptide (N-BNP) level and contrast-enhanced MRI in patients after acute myocardial infarction (MI). Methods: Eighty-two patients were studied. Venous blood samples were obtained 3 days after MI and MRI was performed from 2 to 7 days after MI, with determination of left ventricular function and acquisition of perfusion data after injection of gadolinium-DTPA. First-pass images (FPI) and Delayed contrast-enhanced (CE) images were analyzed using a 17-segment model, and the extent of transmurality was determined by a visual score. Results: Univariate analysis showed that age (P < 0.001), sex (P < 0.02), Left Ventricular Ejection Fraction (LVEF) <45%(P < 0.002), creatinine (P < 0.05) and delayed CE-MR images (P < 0.006)were predictors of a supramedian N-BNP level. FPI was not a predictor in this univariate analysis (P < 0.078). In a multivariate model, only age, LVEF <45% and delayed CE-MRI were associated with an increased N-BNP level. Conclusion: After MI, high N-BNP levels are dependent on the LVEF but also on the myocardial infarct size derived from the delayed CE-MR images.
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Submitted on : Thursday, February 14, 2013 - 10:16:05 AM
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Alexandre Cochet, Marianne Zeller, Yves Cottin, Clothilde Robert-Valla, Alain Lalande, et al.. The extent of myocardial damage assessed by contrast-enhanced MRI is a major determinant of N-BNP concentration after myocardial infarction. European Journal of Heart Failure, Oxford University Press (OUP), 2004, 6 (5), pp.555-560. ⟨10.1016/j.ejheart.2003.11.012⟩. ⟨hal-00788257⟩

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