@article{17304,
  author = {Kruszewski K. and Scott A. and Barclay J. and Croal B. and Oh J. and Hillis Graham and Møller J. and Small G.},
  title = {Noninvasive assessment of left ventricular filling pressure after acute myocardial infarction: a prospective study of the relative prognostic utility of clinical assessment, echocardiography, and B-type natriuretic peptide},
  abstract = {<p>
BACKGROUND: Elevated left ventricular filling pressure after acute myocardial infarction (AMI) may be identified using clinical assessment, echocardiography, and B-type natriuretic peptide (BNP) levels. All of these predict outcome in this setting. There are, however, no data assessing their relative prognostic value. The current study addresses this. METHODS: Four hundred patients underwent detailed echocardiography and measurement of BNP levels after AMI (median 1 day). The study end points were (1) a composite of death, recurrent AMI, and/or admission to hospital with heart failure within 1 year and (2) all-cause mortality during medium-term follow-up (median 2.9 years). RESULTS: Both an elevated ratio of early transmitral flow to early mitral annulus velocity (E/e') and higher BNP levels were associated with an increased risk of an adverse event within the first year (odds ratio 6.14 for E/e'&gt;15, P &lt; .001; odds ratio 1.19 per 50-pg/mL increase in BNP, P &lt; .001) and medium-term mortality (hazard ratio 4.67 for E/e'&gt;15, P &lt; .001; hazard ratio 1.10 per 50-pg/mL increase in BNP, P &lt; .001). Among patients with BNP levels higher than the median or in the upper quartile, an E/e' ratio &gt;15 identified a subgroup at greatest risk of mortality (P &lt; .001 for both). CONCLUSIONS: The E/e' ratio and BNP levels play important and complementary roles in the risk stratification of patients after AMI.
</p>
},
  year = {2010},
  journal = {American Heart Journal},
  volume = {159},
  edition = {2010/01/28},
  number = {1},
  pages = {47-54},
  isbn = {1097-6744 (Electronic)0002-8703 (Linking)},
  note = {Kruszewski, KirstenScott, Anne EBarclay, Justin LSmall, Gary RCroal, Bernard LMoller, Jacob EOh, Jae KHillis, Graham SComparative StudyResearch Support, Non-U.S. Gov'tUnited StatesAmerican heart journalAm Heart J. 2010 Jan;159(1):47-54.},
  language = {eng},
}