Panou Fotis K, Kotseroglou Vasiliki K, Lakoumentas John A, Chrysanthopoulou Stavroula A, Armeniakos John A, Stratigou Theodora, Veve Helen, Zacharoulis Apostolos A
Cardiology Department of Athens General Hospital G. Genimatas, Athens, Greece.
Hellenic J Cardiol. 2006 Nov-Dec;47(6):344-51.
Brain natriuretic peptide (BNP) correlates well with left ventricular wall hypertrophy and the severity of left ventricular outflow tract (LVOT) obstruction in patients with hypertrophic cardiomyopathy (HCM). The purpose of this study was to investigate the correlation of BNP levels with clinical status and left ventricular function in HCM patients.
In 32 patients with HCM (age 58 +/- 14 years) we evaluated: (a) the severity of dyspnea and angina; (b) BNP plasma levels; (c) left ventricular wall thickness, sphericity index and mitral regurgitation; (d) LVOT obstruction; (e) ejection fraction; (f) left ventricular diastolic function, global and regional, by tissue Doppler imaging.
BNP plasma levels correlated positively with dyspnea (r = 0.460, p < 0.001), angina (r = 0.460, p = 0.008), mitral regurgitation (r = 0.600, p < 0.001), thickness of interventricular septum (r = 0.526, p = 0.002), and LVOT obstruction (r = 0.551, p = 0.001 and r = 0.603, p < 0.001 for latent obstruction), while they were negatively correlated with left ventricular sphericity index (r = -0.368, p = 0.038). BNP plasma levels were strongly correlated with E/Vp and E/Eal (Vp: flow propagation velocity, Eal: E on the lateral side of the mitral annulus), representing the left ventricular filling pressures, and with some other parameters of regional diastolic function: Ams (A at the mid-segment of the interventricular septum) r = -0.518, p = 0.002; Aas (A on the septal side of the mitral annulus) r = -0.454, p = 0.009; Aal (A on the lateral side of the mitral annulus) r = -0.467, p = 0.007. From multiple regression analysis, angina and the ratio E/Eal were the strongest predictors of BNP plasma levels.
BNP plasma levels in HCM patients can be used as an adjunctive objective method of evaluating cardiac dysfunction through their correlation with angina and left ventricular filling pressures.
脑钠肽（BNP）与肥厚型心肌病（HCM）患者的左心室壁肥厚及左心室流出道（LVOT）梗阻的严重程度密切相关。本研究旨在探讨HCM患者BNP水平与临床状况及左心室功能的相关性。
在32例HCM患者（年龄58±14岁）中，我们评估了：（a）呼吸困难和心绞痛的严重程度；（b）血浆BNP水平；（c）左心室壁厚度、球形指数和二尖瓣反流；（d）LVOT梗阻；（e）射血分数；（f）通过组织多普勒成像评估左心室舒张功能，包括整体和局部舒张功能。
血浆BNP水平与呼吸困难（r = 0.460，p < 0.001）、心绞痛（r = 0.460，p = 0.008）、二尖瓣反流（r = 0.600，p < 0.001）、室间隔厚度（r = 0.526，p = 0.002）及LVOT梗阻（潜在梗阻时r = 0.551，p = 0.001；r = 0.603，p < 0.001）呈正相关，而与左心室球形指数呈负相关（r = -0.368，p = 0.038）。血浆BNP水平与代表左心室充盈压的E/Vp和E/Eal（Vp：血流传播速度，Eal：二尖瓣环外侧的E）以及一些其他局部舒张功能参数密切相关：室间隔中段的A（Ams）r = -0.518，p = 0.002；二尖瓣环间隔侧的A（Aas）r = -0.454，p = 0.009；二尖瓣环外侧的A（Aal）r = -0.467，p = 0.007。多元回归分析显示，心绞痛和E/Eal比值是血浆BNP水平的最强预测因子。
HCM患者的血浆BNP水平可通过与心绞痛及左心室充盈压的相关性，作为评估心脏功能障碍的辅助客观方法。
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