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B型利钠肽与疑似心力衰竭症状患者异质性群体的临床及超声心动图参数的相关性

Correlation of B type natriuretic peptides with clinical and echocardiographic parameters in heterogeneous population of patients with symptoms suggestive of heart failure.

作者信息

Piechota W N, Piechota W T, Bejm J, Wierzbowski R, Michałkiewicz D

机构信息

Department of Internal Diseases and Cardiology, Military Medical Institute, ul. Szaserów 128, 00-909 Warsaw, Poland.

出版信息

Adv Med Sci. 2006;51:164-7.

Abstract

PURPOSE

NT-proBNP and BNP concentrations in CHF correlate with NYHA class and LVEE Little research has been conducted to compare the clinical performance of these two natriuretic peptides in heterogeneous CHF population. Purpose: to evaluate and compare the clinical performance of NT-proBNP and BNP in heterogeneous group of CHF patients on the basis of these peptides' correlation with NYHA class, LVEF and WMI measured by echocardiography.

MATERIAL AND METHODS

Consecutive patients admitted for suspected of CHE Blood samples were drawn for NT-proBNP, BNP, creatinine and echocardiography was performed.

RESULTS

71 patients were included. CHF was diagnosed in 53. Sensitivity of NT-proBNP and BNP in diagnosing CHF was 83% and 94% respectively (P = 0.079). Levels of both peptides correlated equally well with NYHA class (R = 0.537, p < 0.001; R = 0.473, P < 0.001), LVEF (R = -0.623, p < 0.001; R = -0.601, P < 0.001) and WMI (R = 0.590, P < 0.001; R = 0.527, P = 0.001). Creatinine correlated with both peptides, age correlated with NT-proBNP. No difference between sexes was found in both peptides' concentrations. In multivariate analysis independent determinants of BNP were LVEF, presence of valvular disease and NYHA class. In case of NT-proBNP age and creatinine also displayed independent influence.

CONCLUSIONS

NT-proBNP and BNP show good sensitivity in detecting CHE Levels of both peptides correlate equally well with clinical and echocardiographic parameters of CHF, which makes them equally adequate in biochemical staging of CHF's severity regardless of its underlying cause. Levels of natriutretic peptides reflect contractile dysfunction, valvular disease and clinical condition. Age and creatinine concentration but not patients' sex should additionally be considered when measuring NT-proBNP.

摘要

目的

慢性心力衰竭(CHF)患者的N末端脑钠肽原(NT-proBNP)和脑钠肽(BNP)浓度与纽约心脏协会(NYHA)心功能分级及左心室射血分数(LVEF)相关。关于比较这两种利钠肽在异质性CHF人群中的临床性能的研究较少。目的:基于NT-proBNP和BNP与NYHA心功能分级、LVEF及通过超声心动图测量的心肌梗死面积(WMI)的相关性,评估并比较NT-proBNP和BNP在异质性CHF患者组中的临床性能。

材料与方法

连续纳入疑似CHF的患者。采集血样检测NT-proBNP、BNP、肌酐,并进行超声心动图检查。

结果

共纳入71例患者,其中53例诊断为CHF。NT-proBNP和BNP诊断CHF的敏感性分别为83%和94%(P = 0.079)。两种肽的水平与NYHA心功能分级(R = 0.537,p < 0.001;R = 0.473,P < 0.001)、LVEF(R = -0.623,p < 0.001;R = -0.601,P < 0.001)及WMI(R = 0.590,P < 0.001;R = 0.527,P = 0.001)的相关性均良好。肌酐与两种肽相关,年龄与NT-proBNP相关。两种肽的浓度在性别上无差异。多因素分析显示,BNP的独立决定因素为LVEF、瓣膜病的存在及NYHA心功能分级。对于NT-proBNP,年龄和肌酐也显示出独立影响。

结论

NT-proBNP和BNP在检测CHF方面具有良好的敏感性。两种肽的水平与CHF的临床及超声心动图参数的相关性均良好,这使得它们在CHF严重程度的生化分期中同样适用,无论其潜在病因如何。利钠肽水平反映收缩功能障碍、瓣膜病及临床状况。检测NT-proBNP时应额外考虑年龄和肌酐浓度,而不是患者性别。

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