Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Original article / research
Year : 2017 | Month : November | Volume : 11 | Issue : 11 | Page : OC01 - OC04

Usefulness of B-Type Natriuretic Peptide in Predicting the Involvement of Right Ventricle in Acute Inferior Wall Myocardial Infarction

Ramalingam Aroutselvan, Victor Ashok, Sethumadhavan Raghothaman, Hannah Sugirthabai Rajilarajendran

1. Assistant Professor, Department of Cardiology, Government Chengalpattu Medical College, Chengalpattu, Tamil Nadu, India. 2. Associate Professor, Department of Cardiology, Government Chengalpattu Medical College, Chengalpattu, Tamil Nadu, India. 3. Assistant Professor, Department of Cardiology, Government Chengalpattu Medical College, Chengalpattu, Tamil Nadu, India. 4. Professor, Department of Anatomy, Chettinad Hospital and Research Institute, Kelambakkam,Chennai, Tamil Nadu, India.

Correspondence Address :
Dr. Victor Ashok,
7D, KG Towers, 100 Feet Bypass Road, Velachery, Chennai-600042, Tamil Nadu, India.
E-mail: drashokcardio@yahoo.co.in

Abstract

Introduction: Cardiovascular Disease (CVD) is the leading cause of deaths globally as the death rate due to CVD has increased from 26% in 1990 to 29.5% in 2010. The Acute Coronary Syndrome (ACS) includes acute Myocardial Infarction (MI) with ST segment elevation, Non-ST Segment Elevation Myocardial Infarction (NSTEMI) and Unstable Angina (UA). Isolated infarction of the right ventricle is rare and is commonly associated with Inferior Wall MI (IWMI) or Posterior Wall MI (PWMI). B-type Natriuretic Peptide (BNP) is one of the biomarkers which has been evaluated during acute MI.

Aim: In this study, the usefulness of BNP in predicting the involvement of Right Ventricle (RV) in acute ST elevation with IWMI and PWMI was assessed.

Materials and Methods: The study was a prospective observational study, done on 64 patients less than 60 years of age. The study was conducted over a period of four months at Rajiv Gandhi General Hospital, Madras Medical College, Chennai., Tamil Nadu, India. The patients with diagnosis of IWMI, IW with RVMI, IW with PWMI, IW and PW with RVMI were included. BNP levels, Left Ventricular Ejection Fraction (LVEF) and troponin I were measured. Killip class was also observed and patients were classified and compared against different levels of BNP.

Results: When IWMI is associated with RV, PW or RV with PW involvement, BNP level was increased to more than 900 pg/ml, than in isolated IWMI. This increment was statistically significant. There was severe increase in BNP in those having LVEF =30%, and majority of patients were in the range of 30-50%. All the patients in Killip class III and IV had severe BNP increase as did those patients with cardiac troponin levels between the range of 2-4 ng/ml.

Conclusion: All the findings are statistically significant and prove that severe BNP increase in acute IWMI is definitely a predictor of associated RV, PW or RV with PW involvement. LVEF has a significant inverse correlation with BNP levels, as the BNP rises, LVEF shows a steady decline. Killip class also shows a poor prognosis with elevated BNP. Troponin I levels are higher with increase in BNP.

Keywords

BNP, Cardiovascular disease, Predictor

How to cite this article :

Ramalingam Aroutselvan, Victor Ashok, Sethumadhavan Raghothaman, Hannah Sugirthabai Rajilarajendran. USEFULNESS OF B-TYPE NATRIURETIC PEPTIDE IN PREDICTING THE INVOLVEMENT OF RIGHT VENTRICLE IN ACUTE INFERIOR WALL MYOCARDIAL INFARCTION. Journal of Clinical and Diagnostic Research [serial online] 2017 November [cited: 2018 Jan 20 ]; 11:OC01-OC04. Available from
http://jcdr.net/back_issues.asp?issn=0973-709x&year=2017&month=November&volume=11&issue=11&page=OC01-OC04&id=10801

DOI and Others

DOI: 10.7860/JCDR/2017/29173.10801

Date of Submission: Apr 09, 2017
Date of Peer Review: May 26, 2017
Date of Acceptance: Sep 06, 2017
Date of Publishing: Nov 01, 2017

FINANCIAL OR OTHER COMPETING INTERESTS: None.

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