Kim Seon Woon, Park Seung Woo, Lim Seong-Hoon, Kwon Sung Uk, Choi Yu Jeong, Park Man Ki, Lee Sang-Chol, Lee Sang Hoon, Park Jeong Euy, Jeon Eun-Seok
Department of Medicine, Cardiac and Vascular Center, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.
Clin Cardiol. 2006 Apr;29(4):155-60. doi: 10.1002/clc.4960290406.
N-terminal pro-brain natriuretic peptide (NT-proBNP) is increased in patients with hypertrophic cardiomyopathy (HCM); however, the determinants of NT-proBNP level have not been clarified in HCM.
This study was performed to determine the relationship between NT-proBNP levels and various echocardiographic variables of patients with HCM and normal left ventricular ejection fraction (LVEF).
We assessed plasma NT-proBNP levels and echocardiographic variables of 36 patients (19 men, 58 +/- 14 years) with HCM and an LVEF of > or = 55%. Echocardiographic variables measured were LV wall thickness, end-diastolic LV internal dimension (LVIDd) and volume (LVEDV), LV mass, and LV mass index (LV mass/body surface area, LVMI). Left ventricular outflow tract pressure gradient, transmitral E and A velocities, deceleration time (DT) of the transmitral E wave, and septal annular E' velocity were measured by Doppler technique. The relationship between echocardiographic variables and plasma NT-proBNP level was analyzed.
The plasma NT-proBNP level was 775.2 +/- 994.2 pg/ml (range 33.1-4729.0 pg/ml). It showed positive correlations with LV end-diastolic septal thickness (r = 0.39, p = 0.010) and LVMI (r = 0.27, p = 0.050), while it revealed negative correlations with LVIDd (r = -0.44, p = 0.004), LVEDV (r = -0.44, p = 0.004) and DT(r = -0.31,p = 0.034). The NT-proBNP level was higher in the patients with than in those without LV diastolic dysfunction (p = 0.033) and was independently related to LVIDd (p = 0.001), LVMI (p = 0.006) and DT (p = 0.031) by multivariate analysis.
In patients with HCM and normal LVEF, the amount of LV hypertrophy and LV diastolic dysfunction may exert a significant role in determining plasma NT-proBNP level.
肥厚型心肌病（HCM）患者的N末端脑钠肽原（NT-proBNP）水平升高；然而，HCM中NT-proBNP水平的决定因素尚未明确。
本研究旨在确定HCM且左心室射血分数（LVEF）正常的患者NT-proBNP水平与各种超声心动图变量之间的关系。
我们评估了36例（19例男性，年龄58±14岁）HCM且LVEF≥55%患者的血浆NT-proBNP水平和超声心动图变量。测量的超声心动图变量包括左心室壁厚度、舒张末期左心室内径（LVIDd）和容积（LVEDV）、左心室质量和左心室质量指数（左心室质量/体表面积，LVMI）。通过多普勒技术测量左心室流出道压力阶差、二尖瓣E和A速度、二尖瓣E波减速时间（DT）以及室间隔环E'速度。分析超声心动图变量与血浆NT-proBNP水平之间的关系。
血浆NT-proBNP水平为775.2±994.2 pg/ml（范围33.1 - 4729.0 pg/ml）。它与左心室舒张末期室间隔厚度呈正相关（r = 0.39，p = 0.010）和LVMI呈正相关（r = 0.27，p = 0.050），而与LVIDd呈负相关（r = -0.44，p = 0.004）、LVEDV呈负相关（r = -0.44，p = 0.004）以及DT呈负相关（r = -0.31，p = 0.034）。有左心室舒张功能障碍的患者NT-proBNP水平高于无左心室舒张功能障碍的患者（p = 0.033），多因素分析显示其与LVIDd（p = 0.001）、LVMI（p = 0.006）和DT（p = 0.031）独立相关。
在HCM且LVEF正常的患者中，左心室肥厚程度和左心室舒张功能障碍可能在决定血浆NT-proBNP水平方面发挥重要作用。
