Faludi Réka, Tóth Levente, Pótó László, Cziráki Attila, Simor Tamás, Papp Lajos
Pécsi Tudományegyetem, Altalános Orvostudományi Kar, Szívgyógyászati Klinika, Pécs.
Orv Hetil. 2005 Jan 2;146(1):23-6.
Preload-independent pulsed tissue Doppler echocardiography (TDI) and conventional pulsed Doppler echocardiography were used to assess the global left ventricular diastolic function in patients with hypertrophic cardiomyopathy (HCM). Levels of B-type natriuretic peptide (BNP) could be elevated in patients with isolated left ventricular diastolic dysfunction.
The study was to investigate the correlation between BNP levels and the parameters measured by conventional echocardiography and TDI in patients with HCM.
32 consecutive patients with HCM (21 male, 11 female, mean age 47 +/- 14 years) were studied. Inclusion criteria were: normal sinus rhythm; ejection fraction > or = 50%; absence of moderate to severe mitral regurgitation or prosthetic mitral valve.
In addition to the conventional transmitral flow patterns (E, A, E/A, DT, IVRT) myocardial early (Ea) and late diastolic (Aa) velocities were measured at the lateral and septal border of the mitral annulus by ATL HDI 5000 ultrasound system. Ea/Aa and E/Ea ratios were calculated. NT-proBNP levels were measured by Roche-Elecsys test (immunoassay). Because the distribution of BNP values did not appear to be normal, the values were transformed into a natural logarithm (InBNP).
Mean BNP level was 543 +/- 845 pg/ml. BNP levels negatively correlated with lateral Aa values (r = -0.59, p < 0.001). No significant relationship was observed between BNP levels and other echocardiographic parameters. By stepwise multiple linear regression analysis the only significant predictor of InBNP was lateral Aa value, too (r = -0.467, p < 0.05).
Significant correlation was found between BNP levels and a single TDI parameter characterizing left atrial systolic function, but there was no significant correlation between BNP levels and global left ventricular diastolic function characterized by either conventional echocardiographic or TDI parameters.
采用与前负荷无关的脉冲组织多普勒超声心动图（TDI）和传统脉冲多普勒超声心动图评估肥厚型心肌病（HCM）患者的左心室整体舒张功能。孤立性左心室舒张功能障碍患者的B型利钠肽（BNP）水平可能升高。
本研究旨在探讨HCM患者BNP水平与传统超声心动图和TDI所测参数之间的相关性。
对32例连续性HCM患者（男21例，女11例，平均年龄47±岁）进行研究。纳入标准为：窦性心律正常；射血分数≥50%；无中度至重度二尖瓣反流或人工二尖瓣。
除传统经二尖瓣血流模式（E、A、E/A、DT、IVRT）外，采用ATL HDI 5000超声系统在二尖瓣环外侧和室间隔边缘测量心肌舒张早期（Ea）和晚期（Aa）速度。计算Ea/Aa和E/Ea比值。采用罗氏电化学发光免疫分析法测定NT-proBNP水平。由于BNP值分布似乎不正常，将这些值转换为自然对数（InBNP）。
平均BNP水平为543±845 pg/ml。BNP水平与外侧Aa值呈负相关（r = -0.59，p < 0.001）。未观察到BNP水平与其他超声心动图参数之间存在显著关系。通过逐步多元线性回归分析，InBNP的唯一显著预测因子也是外侧Aa值（r = -0.467，p < 0.05）。
发现BNP水平与表征左心房收缩功能的单一TDI参数之间存在显著相关性，但BNP水平与以传统超声心动图或TDI参数表征的左心室整体舒张功能之间无显著相关性。
