Tekten Tarkan, Yenisey Cigdem, Ceyhan Ceyhun, Onbasili Alper O, Discigil Guzel, Kaya Murat, Unal Selim
Department of Cardiology, Medical Faculty, Adnan Menderes University, Aydin, Turkey.
Echocardiography. 2007 Sep;24(8):837-42. doi: 10.1111/j.1540-8175.2007.00490.x.
This study was designed to determine how N-terminal pro brain-natriuretic peptide (NT-proBNP) levels correlate with cyclic variation of integrated backscatter (CVIBS) as a reflection of abnormal diastolic function in hypertension.
Forty essentially hypertensive patients were studied. CVIBS values were obtained from the septal wall in the parasternal long-axis view. Twelve had normal diastolic function, 18 had impaired relaxation, and 10 had pseudonormal pattern.
Patients with normal diastolic function had a mean NT-proBNP concentration of 34 +/- 17 pg/ml and a mean CVIBS value of 7.1 +/- 0.9 dB; those with impaired relaxation had a mean NT-proBNP concentration of 71 +/- 25 pg/ml and a mean CVIBS value of 6.7 +/- 1.1 dB. Patients with pseudonormal pattern had the highest NT proBNP levels (206 +/- 75 pg/ml) and lowest CVIBS values (5.7 +/- 0.9 dB). An NT-proBNP value of 62 pg/ml had a sensitivity of 83% and a specificity of 91%; a CVIBS value of 7.2 dB had a sensitivity of 83.3% and a specificity of 66.7% for detecting diastolic dysfunction. An NT-proBNP value of 120 pg/ml had a sensitivity of 76% and a specificity of 96%; a CVIBS value of 6.1 dB had a sensitivity of 87.5% and a specificity of 75% for detecting severe diastolic dysfunction. A close correlation was found between the NT-proBNP and CVIBS values (r: 0.54, P < 0.05).
Combinative use of NT-proBNP and CVIBS can detect the presence of diastolic abnormalities on echocardiography. A good correlation was found between the NT-proBNP and CVIBS values in detecting diastolic dysfunction in essentially hypertensive patients.
本研究旨在确定N末端脑钠肽前体（NT-proBNP）水平与背向散射积分的周期性变化（CVIBS）之间的相关性，以反映高血压患者舒张功能异常。
对40例原发性高血压患者进行了研究。在胸骨旁长轴视图中从室间隔壁获取CVIBS值。12例舒张功能正常，18例舒张功能减退，10例呈假性正常化模式。
舒张功能正常的患者NT-proBNP平均浓度为34±17 pg/ml，CVIBS平均值为7.1±0.9 dB；舒张功能减退的患者NT-proBNP平均浓度为71±25 pg/ml，CVIBS平均值为6.7±1.1 dB。呈假性正常化模式的患者NT-proBNP水平最高（206±75 pg/ml），CVIBS值最低（5.7±0.9 dB）。NT-proBNP值为62 pg/ml时，检测舒张功能障碍的灵敏度为83%，特异度为91%；CVIBS值为7.2 dB时，检测舒张功能障碍的灵敏度为83.3%，特异度为66.7%。NT-proBNP值为120 pg/ml时，检测严重舒张功能障碍的灵敏度为76%，特异度为96%；CVIBS值为6.1 dB时，检测严重舒张功能障碍的灵敏度为87.5%，特异度为75%。发现NT-proBNP与CVIBS值之间存在密切相关性（r：0.54，P<0.05）。
联合使用NT-proBNP和CVIBS可在超声心动图上检测到舒张功能异常。在原发性高血压患者中，NT-proBNP与CVIBS值在检测舒张功能障碍方面存在良好的相关性。
