[Clinical studies on level of N-terminal portion of brain natriuretic in the treatment and prognosis of Chinese patients with chronic left heart failure].

OBJECTIVE

To study the relationship of the level of N-terminal portion of brain natriuretic (NT-ProBNP) with the treatment and prognosis of patients with acute attack of chronic left heart failure.

METHODS

Patients (age range 18-80 years) with decompensated heart failure treated in the emergency department in Fuwai Hospital were included in this study. Dynamic changes of plasma levels of NT-ProBNP, angiotensin (AO), renin activity (PRA), angiotensin II (AT II) and aldosterone (ALD) were detected by enzyme linked immunoadsorbent assay (ELISA) before anti-cardiac failure treatment and 3-5, 5-7 days after the treatment. All enrolled patients were followed up for 2 years after leaving hospital, and cardiovascular events such as death, myocardial infarction, worsening of heart failure, severe arrhythmia or delayed discharge from hospital were recorded.

RESULTS

Compared with baseline level at admission, plasma NT-ProBNP levels were lowered on 3rd -5th day and 5th-7th day after admission and treatment (both P<0.05) in 44 patients with chronic left heart failure, but there was no difference in NT-ProBNP levels between the 3rd-5th and 5th -7th day after treatment. The levels of plasma NT-ProBNP increased much higher at all observation times in patients with cardiovascular events than without the events (all P<0.05), but the changes in AO, PRA, ATII and ALD showed no significant difference between two groups (all P>0.05).

CONCLUSION

During acute onset, plasma NT-ProBNP levels in patients with chronic left heart failure can be lowered at 3-7 days after admission and treatment. Higher baseline levels of plasma NT-ProBNP may have certain predictive values for long term prognosis in patients with chronic left heart failure.