慢性心力衰竭患者运动期间的舒张功能和脑钠肽变化可预测耗氧量。

Diastolic function and BNP changes during exercise predict oxygen consumption in chronic heart failure patients.

作者信息

Ciampi Quirino, Borzillo Gabriele, Barbato Emanuele, Petruzziello Bruno, Betocchi Sandro, Villari Bruno

机构信息

Division of Cardiology, Fatebenefratelli Hospital, Benevento, Italy.

出版信息

Scand Cardiovasc J. 2009 Feb;43(1):17-23. doi: 10.1080/14017430802175720.

DOI:10.1080/14017430802175720

PMID:18609042

Abstract

UNLABELLED

B-type natriuretic peptide (BNP) is a diagnostic and prognostic marker in heart failure (CHF) patients.

AIM

To assess the relation between BNP, diastolic function and exercise capacity in CHF patients.

METHODS

Fifty CHF patients underwent cardiopulmonary exercise testing. BNP levels were determined at baseline and at peak exercise. Patients were divided in two groups: with lower (<14 ml/kg/min) or higher (>or=14 ml/kg/min) peak oxygen consumption (VO(2)).

RESULTS

Seventeen patients with lower peak VO(2) showed larger incidence of restrictive pattern of the transmitral flow (7/17 vs 4/33, p =0.036). E/Ea ratio was inversely related with peak VO(2) (r =-0.419, p =0.004) and directly related with BNP levels at baseline (r =0.449, p =0.001) and at peak exercise (r =0.475, p =0.001). LV ejection fraction was similar in the two groups. Independent predictors of exercise tolerance were E/Ea ratio (p =0.003), lg BNP at baseline (p =0.034) and increase in lg BNP during exercise (p =0.038).

CONCLUSIONS

In CHF patients, E/Ea ratio is a predictor of exercise tolerance and is related with BNP level at rest and at peak exercise.

摘要

未标注

B型利钠肽（BNP）是心力衰竭（CHF）患者的诊断和预后标志物。

目的

评估CHF患者中BNP、舒张功能和运动能力之间的关系。

方法

50例CHF患者进行了心肺运动试验。在基线和运动峰值时测定BNP水平。患者分为两组：峰值耗氧量（VO₂）较低（<14 ml/kg/min）或较高（≥14 ml/kg/min）。

结果

17例峰值VO₂较低的患者二尖瓣血流限制性模式的发生率更高（7/17对4/33，p =0.036）。E/Ea比值与峰值VO₂呈负相关（r = -0.419，p =0.004），与基线时（r =0.449，p =0.001）和运动峰值时（r =0.475，p =0.001）的BNP水平呈正相关。两组的左心室射血分数相似。运动耐量的独立预测因素是E/Ea比值（p =0.003）、基线时的lg BNP（p =0.034）和运动期间lg BNP的增加（p =0.038）。