慢性心力衰竭患者脑钠肽（BNP）与N末端脑钠肽原（NT-proBNP）经心差异的直接比较

Direct comparison of transcardiac difference between brain natriuretic peptide (BNP) and N-terminal pro-BNP in patients with chronic heart failure.

作者信息

Tsutamoto Takayoshi, Sakai Hiroshi, Ishikawa Chitose, Fujii Masanori, Tanaka Toshinari, Yamamoto Takashi, Takashima Hiroyuki, Ohnishi Masato, Wada Atsuyuki, Horie Minoru

机构信息

Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Tsukinowa, Seta, Otsu 520-2192, Japan.

出版信息

Eur J Heart Fail. 2007 Jun-Jul;9(6-7):667-73. doi: 10.1016/j.ejheart.2007.01.003. Epub 2007 Mar 23.

DOI:10.1016/j.ejheart.2007.01.003

PMID:17360233

Abstract

BACKGROUND

Direct comparison of transcardiac increase in brain natriuretic peptide (BNP) and NT-pro-BNP has not been performed previously.

AIMS

To evaluate the relation between BNP and NT-pro-BNP secretion, plasma levels and renal function.

METHODS

We measured the plasma levels of BNP and NT-pro-BNP in the aortic root and coronary sinus in 326 consecutive patients with chronic heart failure (CHF). Patients were divided into two groups [group I: estimated glomerular filtration rate (eGFR)>or=60 mL/min and group II: eGFR<60 mL/min].

RESULTS

The molar level of the transcardiac increase in NT-pro-BNP is lower than that of BNP. There were no differences in haemodynamics or the transcardiac gradient of BNP and NT-pro-BNP between group I and group II. The molar ratio of the plasma NT-pro-BNP to BNP was significantly higher in group II than in group I. By stepwise multivariate analyses, not only the left ventricular (LV) ejection fraction and LV end-diastolic pressure, but also eGFR, LV mass index (LVMI) and haemoglobin were independent predictors of plasma NT-pro-BNP and BNP.

CONCLUSION

The molar level of the transcardiac increase in NT-pro-BNP is lower than that of BNP; however, the influence of renal function on plasma NT-pro-BNP is greater than that on BNP.

摘要

背景

此前尚未对经心脏脑钠肽（BNP）和N末端B型利钠肽原（NT-pro-BNP）升高情况进行直接比较。

目的

评估BNP与NT-pro-BNP分泌、血浆水平及肾功能之间的关系。

方法

我们对326例连续性慢性心力衰竭（CHF）患者的主动脉根部和冠状窦血浆BNP和NT-pro-BNP水平进行了测量。患者被分为两组[I组：估计肾小球滤过率（eGFR）≥60 mL/分钟；II组：eGFR＜60 mL/分钟]。

结果

NT-pro-BNP经心脏升高的摩尔水平低于BNP。I组和II组之间在血流动力学或BNP与NT-pro-BNP的经心脏梯度方面无差异。II组血浆NT-pro-BNP与BNP的摩尔比显著高于I组。通过逐步多因素分析，不仅左心室（LV）射血分数和左心室舒张末期压力，而且eGFR、左心室质量指数（LVMI）和血红蛋白都是血浆NT-pro-BNP和BNP的独立预测因素。