Taléns-Visconti Raquel, Rivera Otero Miguel, Sancho-Tello Ma José, de Burgos Fernando García, Martínez-Dolz Luis, Sevilla Begoña, Climent Vicente, Cortés Raquel, Salvador Antonio, Sogorb Francisco, Miro Vicente, Valero Ricardo, Perez-Boscá Jose Luis, Bertomeu Vicente, Portolés Manuel, Payá Rafael
Research Center La Fe Hospital, Valencia, Spain.
Eur J Echocardiogr. 2006 Jan;7(1):45-52. doi: 10.1016/j.euje.2005.04.014. Epub 2005 Jun 4.
N-terminal pro-brain natriuretic peptide (NT-proBNP) is useful in the diagnosis of heart failure (HF). LV two-dimensional cavity area from end-diastole (LVEDA) and end-systole (LVESA), and LV fractional area change (LVFAC) reflect changes in LV morphology and function without using geometric assumptions. In a multicenter study, we correlated LVEDA, LVESA and LVFAC with NT-proBNP, comparing patients with dilated and ischemic cardiomyopathy.
We studied 106 HF patients. In the dilated group, NT-proBNP correlated with LVEDAI (r=0.6), LVESAI (r=0.7) and LVFAC (r=-0.6), all significant at p<0.001. In patients with ischemic cardiomyopathy we found LVESAI (r=0.3, p<0.05) and LVFAC (r=-0.4, p<0.01). After adjustment for age and BMI, LVFAC and LVESAI were associated in a multiple linear regression analysis with peptide levels (adjusted r(2)=0.5, p<0.001).
In this study we found a good correlation of NT-proBNP with LV cavity areas and LVFAC. Multiple regression analysis showed that when adjusted for age and BMI, LVFAC and LVESAI are independent predictors of NT-proBNP levels in both dilated and ischemic etiologies. Patients with dilated cardiomyopathy showed better results than those with ischemic cardiomyopathy. We think LV areas are a useful and reproducible parameter, do not need geometric assumptions and reflect NT-proBNP plasma levels.
N 末端脑钠肽前体（NT-proBNP）对心力衰竭（HF）的诊断有帮助。左心室舒张末期（LVEDA）和收缩末期（LVESA）的二维腔面积以及左心室面积变化分数（LVFAC）可反映左心室形态和功能的变化，且无需使用几何假设。在一项多中心研究中，我们将 LVEDA、LVESA 和 LVFAC 与 NT-proBNP 进行相关性分析，比较扩张型和缺血性心肌病患者。
我们研究了 106 例 HF 患者。在扩张型心肌病组中，NT-proBNP 与 LVEDAI（r = 0.6）、LVESAI（r = 0.7）和 LVFAC（r = -0.6）相关，所有相关性在 p < 0.001 时均具有统计学意义。在缺血性心肌病患者中，我们发现 LVESAI（r = 0.3，p < 0.05）和 LVFAC（r = -0.4，p < 0.01）。在对年龄和体重指数进行校正后，LVFAC 和 LVESAI 在多元线性回归分析中与肽水平相关（校正 r² = 0.5，p < 0.001）。
在本研究中，我们发现 NT-proBNP 与左心室腔面积和 LVFAC 具有良好的相关性。多元回归分析表明，在对年龄和体重指数进行校正后，LVFAC 和 LVESAI 是扩张型和缺血性病因中 NT-proBNP 水平的独立预测因子。扩张型心肌病患者的结果优于缺血性心肌病患者。我们认为左心室面积是一个有用且可重复的参数，无需几何假设，并能反映 NT-proBNP 的血浆水平。
