Mady Charles, Fernandes Fábio, Arteaga Edmundo, Ramires Felix José Alvarez, Buck Paula de Cássia, Salemi Vera Maria Cury, Ianni Barbara Maria, Nastari Luciano, Dias Ricardo Ribeiro
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
Arq Bras Cardiol. 2008 Jul;91(1):46-54. doi: 10.1590/s0066-782x2008001300008.
NT pro-BNP is a marker of systolic and diastolic dysfunction.
To determine NT pro-BNP levels in patients with chagasic, hypertrophic, and restrictive heart diseases, as well as with pericardial diseases, and their relation to echocardiographic measurements of systolic and diastolic dysfunction.
A total of 145 patients were divided into the following groups: 1) Chagas' heart disease (CHD)--14 patients; 2) hypertrophic cardiomyopathy (HCM)--71 patients; 3) endomyocardial fibrosis (EMF)--26 patients; 4) pericardial effusion (PE)--18 patients; and 5) constrictive pericarditis (CP)--16 patients. The control group was comprised of 40 individuals with no heart disease. The degree of myocardial impairment and pericardial effusion were assessed by two-dimensional echocardiography and the degree of restriction by pulsed Doppler transmitral flow. The diagnosis of CP was confirmed through magnetic resonance imaging. NT pro-BNP levels were determined through electrochemiluminescence immunoassay.
NT pro-BNP was increased (p < 0.001) in CHD (median = 513.8 pg/ml), HCM (median = 848 pg/ml), EMF (median = 633 pg/ml), CP (median = 568 pg/ml), and PE (median = 124 pg/ml), when compared with the control group (median = 28 pg/ml). No statistically significant differences were found between CP and EMF (p = 0.14). In the hypertrophic group, NT pro-BNP was correlated with left atrial size (r = 0.40; p < 0.001) and with E/Ea ratio (p < 0.01). In the restrictive group, there was a trend of correlation with E-wave peak velocity (r = 0.439; p = 0.06).
NT pro-BNP is increased in the different cardiomyopathies and pericardial diseases and is correlated with the degree of systolic and diastolic dysfunction.
N末端脑钠肽前体（NT pro-BNP）是收缩功能和舒张功能障碍的一个标志物。
测定患有恰加斯病性、肥厚性和限制性心脏病以及心包疾病患者的NT pro-BNP水平，以及它们与收缩功能和舒张功能障碍的超声心动图测量值之间的关系。
总共145例患者被分为以下几组：1）恰加斯心脏病（CHD）——14例患者；2）肥厚型心肌病（HCM）——71例患者；3）心内膜心肌纤维化（EMF）——26例患者；4）心包积液（PE）——18例患者；5）缩窄性心包炎（CP）——16例患者。对照组由40名无心脏病的个体组成。通过二维超声心动图评估心肌损害程度和心包积液情况，通过脉冲多普勒二尖瓣血流评估受限程度。CP的诊断通过磁共振成像得以证实。通过电化学发光免疫分析法测定NT pro-BNP水平。
与对照组（中位数 = 28 pg/ml）相比，CHD（中位数 = 513.8 pg/ml）、HCM（中位数 = 848 pg/ml）、EMF（中位数 = 633 pg/ml）、CP（中位数 = 568 pg/ml）和PE（中位数 = 124 pg/ml）患者的NT pro-BNP升高（p < 0.001）。CP和EMF之间未发现统计学上的显著差异（p = 0.14）。在肥厚组中，NT pro-BNP与左心房大小相关（r = 0.40；p < 0.001），与E/A比值相关（p < 0.01）。在限制性组中，与E波峰值速度存在相关性趋势（r = 0.439；p = 0.06）。
不同的心肌病和心包疾病中NT pro-BNP升高，且与收缩功能和舒张功能障碍程度相关。
