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Left ventricular remodelling and brain natriuretic peptide after first myocardial infarction
1Department of Cardiology, Ward B22 Office, Sunderland Royal Hospital, Sunderland SR4 7TP, UK. j.g.crilley@ncl.ac.uk
Objective:
To investigate the relation between brain natriuretic peptide (BNP) concentrations and left ventricular remodelling characteristics after acute myocardial infarction.
Design:
Consecutive sample prospective cohort study.
Setting:
District general hospital coronary care unit in the north of England.
Patients:
133 initial survivors of a first myocardial infarction who received thrombolytic treatment.
Interventions:
Patients had transthoracic echocardiography and BNP concentrations measured at three to seven days (early) and two months (late).
Main Outcome Measures:
Wall motion index
Results:
Patients with an early wall motion index of 10% also had higher early and late BNP concentrations (early BNP p = 0.034 and late BNP p = 0.001). Early BNP was significantly associated with one year mortality (p = 0.003).
Conclusions:
Higher BNP concentrations early after first myocardial infarction are associated with adverse left ventricular remodelling characteristics. This may help explain why BNP is such a strong predictor of outcome after myocardial infarction.