Celiński Rafał, Grzywa-Celińska Anna, Cholewiński Witold, Stefaniak Bogusław, Tarkowska Anna
Katedra i Zakłada Medycyny Nuklearnej Akademii Medycznej w Lublinie.
Pol Merkur Lekarski. 2005 Mar;18(105):291-4.
THE AIM of the study was to assess the brain natriuretic peptide (BNP) plasma concentrations in patients with CAD and to evaluate the relationships between BNP levels and such parameters of the left ventricular (LV) systolic function as ejection fraction (LVEF) and peak LV emptying rates (PER).
The study population comprised 69 patients with CAD, aged 30-79 years. All subjects underwent gated equilibrium radionuclide ventriculography at rest. From the data acquired, LVEF and PER were calculated. The plasma BNP concentrations were determined in blood samples taken from patients with CAD and in 18 healthy subjects and the obtained results were compared with those by radionuclide ventriculography. For this purpose patients with CAD were divided into two subgroups: dLVEF (LVEF<50%) and nLVEF (LVEF>50%). Subjects with normal LVEF (nLVEF) were divided into subgroups with PER greater than median value of this parameter and lower than or equal to the median.
In patients with CAD both the BNP concentration and its frequency were significantly higher than in controls. In patients with CAD and dLVEF the BNP concentration was significantly higher than in nLVEF cases. Increased BNP concentration was distinctly more frequent in dLVEF group than in nLVEF, but the difference was not significant (p>0.05). In group with nLVEF, the BNP concentration was higher in patients with PER<2.33 (dPER) in comparison to those with PER>2.3 (p>0.05). Not very close, but statistically significant correlation was found between the BNP level on the one hand and the LVEF and PER on the other.
Increased plasma BNP in patients with CAD seem to depend not only on the degree of the myocardial contraction, but also on the dynamics of the left ventricular emptying. The reason for the BNP elevation in cases with CAD and reduced LV ejection rate but normal EF needs to be investigated.
本研究的目的是评估冠心病患者血浆脑钠肽（BNP）浓度，并评估BNP水平与左心室（LV）收缩功能参数如射血分数（LVEF）和左心室峰值排空率（PER）之间的关系。
研究人群包括69例年龄在30 - 79岁的冠心病患者。所有受试者均进行了静息门控平衡放射性核素心室造影。根据采集的数据计算LVEF和PER。测定冠心病患者及18名健康受试者血样中的血浆BNP浓度，并将所得结果与放射性核素心室造影结果进行比较。为此，将冠心病患者分为两个亚组：dLVEF（LVEF<50%）和nLVEF（LVEF>50%）。LVEF正常（nLVEF）的受试者再分为PER大于该参数中位数和小于或等于中位数的亚组。
冠心病患者的BNP浓度及其频率均显著高于对照组。冠心病合并dLVEF患者的BNP浓度显著高于nLVEF患者。dLVEF组BNP浓度升高明显比nLVEF组更常见，但差异无统计学意义（p>0.05）。在nLVEF组中，PER<2.33（dPER）的患者BNP浓度高于PER>2.3的患者（p>0.05）。发现BNP水平一方面与LVEF，另一方面与PER之间存在不太紧密但具有统计学意义的相关性。
冠心病患者血浆BNP升高似乎不仅取决于心肌收缩程度，还取决于左心室排空动力学。冠心病且左心室射血率降低但EF正常的患者BNP升高的原因有待研究。
