Velocity Vector Imaging and NT-ProBNP to Quantify
Systolic Function and Intraventricular Mechanical
Dyssynchrony to Predict Cardiac Outcome in Patients
with Chronic Heart Failure

Faida O; Oteh M; A Lattif M; Fadillah AW

Abstract

Velocity Vector Imaging and NT-ProBNP to Quantify Systolic Function and Intraventricular Mechanical Dyssynchrony to Predict Cardiac Outcome in Patients with Chronic Heart Failure

Aims: This study sought the prognostic value of velocity vector imaging parameters and NT-proBNP level as independent predictors for the outcome in HF and examining the utility of NT-proBNP level compared to multiple VVI parameters which have not been clarified.

Methods and Results: 108 patients with heart failure underwent speckle tracking with (VVI), systolic function and mechanical dyssynchrony parameters correlating with NTproBNP level and examined their influence on outcome. Average (velocity, strain, strain rate, displacement) ejection fraction, and intraventricular mechanical dyssynchrony based on: SD of time to peak velocity, SD of time to peak displacement and maximal temporal difference of time to peak systolic velocity were significantly associated with clinical events. 948pg/ml NT-pro BNP cutoff value reliable for prediction of cardiac events. In multivariate analysis was revealed that NT- proBNP and strain rate were identified as the independent predictors for cardiac events. VVI parameters compared with NT-proBNP levels, significant correlations were found between NT-proBNP level and longitudinal velocity (R = -0.650, P< 0.0001), displacement (R= -0.646, P<0.0001), strain (R = 0.681, P< 0.0001), strain rate (R = 0.691, P< 0.0001) and ejection fraction(R = -0.807, P< 0.0001). Additionally, log NT-proBNP levels correlated moderately with systolic dyssynchrony (Ts-SD) and small correlation with (Ts-diff) but statistically significant. In multiple linear model revealed that the ejection fraction was the strongest predictor of NT- proBNP level (Beta = - 0.907, P< 0.0001).

Conclusions - Longitudinal mechanical functions’ parameters assessed by VVI have the ability to further identify patients at higher risk of CV events. Use NT-proBNP cutoff value of 948pg/ml is easy and reliable for prediction of mechanical dysfunction and aid identification of patients at highest risk for future cardiac events.

Author(s): Faida O , Oteh M , A Lattif M , Fadillah AW

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