[Asymptomatic ischemic heart dysfunction, echocardiographic changes and NT-proBNP during 2-years observation]

Area of Science:

• Cardiology
• Cardiovascular Medicine
• Clinical Echocardiography

Background:

• Asymptomatic systolic dysfunction of the left ventricle (LV) is defined as the absence of current heart failure symptoms.
• Stable angina pectoris patients may harbor undiagnosed cardiac dysfunction.

Purpose of the Study:

• To analyze echocardiographic parameters and their changes over two years in stable angina patients without heart failure symptoms.
• To determine the role of NT-proBNP in early detection of asymptomatic cardiac dysfunction and its prognostic value.
• To investigate the relationship between left ventricular diastolic dysfunction, comorbidities, and echocardiographic findings.
• To assess the prognostic significance of specific echocardiographic parameters (E/Vp, E/E', Ar) in this patient group.

Main Methods:

• The study included 57 patients with stable ischemic heart disease, evaluated at baseline and after two years.
• Patients were assessed for clinical status, angina severity, risk factors, ECG, lipid profile, and plasma NT-proBNP.
• Participants were categorized into groups based on left ventricular function: normal, impaired diastolic, and impaired systolic and diastolic function.

Main Results:

• Significant correlations were found between left ventricular (LV) dysfunction type and elevated end-diastolic pressure indicators (E/Vp, E/E', Ar, Vp).
• Systolic and diastolic heart dysfunction correlated significantly with NT-proBNP levels.
• After two years, deterioration in heart function was associated with diastolic dysfunction and type II diabetes mellitus in one subgroup.
• Elevated NT-proBNP levels indicate asymptomatic systolic and/or diastolic dysfunction, highlighting its importance for early detection.

Conclusions:

• Elevated NT-proBNP levels are indicative of asymptomatic systolic and/or diastolic cardiac dysfunction in patients with stable angina.
• NT-proBNP serves as a valuable biomarker for the early detection of asymptomatic cardiac dysfunction in this population.
• Specific echocardiographic parameters (E/Vp ≥ 1.5 and E/E' ≥ 8) may indicate more advanced coronary atherosclerosis in patients with stable angina pectoris.