脑钠肽水平在鉴别缩窄性心包炎与限制性心肌病中的效能。
The efficacy of brain natriuretic peptide levels in differentiating constrictive pericarditis from restrictive cardiomyopathy.
作者信息
Leya Ferdinand S, Arab Dinesh, Joyal Dominique, Shioura Krystyna M, Lewis Bruce E, Steen Lowell H, Cho Leslie
机构信息
Division of Cardiology, Section of Interventional Cardiology, Loyola University Medical Center, Maywood, Illinois, USA.
出版信息
J Am Coll Cardiol. 2005 Jun 7;45(11):1900-2. doi: 10.1016/j.jacc.2005.03.050.
OBJECTIVES
We sought to determine the usefulness of brain natriuretic peptide (BNP) measurements to differentiate constrictive pericarditis (CP) from restrictive cardiomyopathy (RCMP).
BACKGROUND
The differentiation of CP from RCMP may be clinically difficult and often requires hemodynamic assessment. No laboratory marker has been shown to differentiate the two conditions.
METHODS
We measured BNP levels in 11 patients suspected of having either CP or RCMP. All patients had hemodynamic assessment the day of BNP measurements.
RESULTS
Six patients had CP and five patients had RCMP based on established hemodynamic criteria. Both CP and RCMP patients had similar elevation in intracardiac pressures. Despite similar pressures, the mean plasma BNP levels were significantly higher in RCMP compared to CP (825.8 +/- 172.2 pg/ml vs. 128.0 +/- 52.7 pg/ml, p < 0.001, respectively).
CONCLUSIONS
The BNP levels are significantly elevated in RCMP compared to CP patients; BNP may prove to be a useful noninvasive marker for the differentiation of the two conditions.
目的
我们试图确定脑钠肽（BNP）检测对于鉴别缩窄性心包炎（CP）与限制型心肌病（RCM）的作用。
背景
CP与RCM的鉴别在临床上可能存在困难，且常常需要进行血流动力学评估。尚无实验室标志物可用于鉴别这两种疾病。
方法
我们对11例疑似患有CP或RCM的患者进行了BNP水平检测。所有患者在检测BNP当天均进行了血流动力学评估。
结果
根据既定的血流动力学标准，6例患者患有CP，5例患者患有RCM。CP和RCM患者的心腔内压力均有类似升高。尽管压力相似，但RCM患者的平均血浆BNP水平显著高于CP患者（分别为825.8±172.2 pg/ml和128.0±52.7 pg/ml，p<0.001）。
结论
与CP患者相比，RCM患者的BNP水平显著升高；BNP可能被证明是鉴别这两种疾病的有用的非侵入性标志物。
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