Kaczyńska Anna, Kostrubiec Maciej, Ciurzyński Michał, Pruszczyk Piotr
Department of Internal Medicine and Cardiology, Medical University of Warsaw, Poland.
Clin Chim Acta. 2008 Dec;398(1-2):1-4. doi: 10.1016/j.cca.2008.07.020. Epub 2008 Jul 24.
Myocardial stretch leads to the natriuretic peptides release in acute or chronic left ventricular dysfunction. However, there is an accumulating evidence that B-type natriuretic peptide (BNP) and its N-terminal fragment (NT-proBNP) may originate from right ventricle and their concentrations are elevated in patients with acute pulmonary embolism (APE) especially when resulting in right ventricular dysfunction (RVD). Recently it is underlined that severity assessment of APE as well as the risk stratification and therapy selection is based both on patients' hemodynamic status and markers of myocardial injury and RVD. BNP and NT-proBNP are helpful in identifying patients with RVD in APE, emerging as an adjunctive tool to echocardiography. Elevated BNP or NT-proBNP levels are also significant predictors of death and/or complicated clinical course in APE.
在急性或慢性左心室功能不全时，心肌牵张会导致利钠肽释放。然而，越来越多的证据表明，B型利钠肽（BNP）及其N端片段（NT-proBNP）可能来源于右心室，并且在急性肺栓塞（APE）患者中其浓度会升高，尤其是在导致右心室功能不全（RVD）时。最近强调，APE的严重程度评估以及风险分层和治疗选择既基于患者的血流动力学状态，也基于心肌损伤和RVD的标志物。BNP和NT-proBNP有助于识别APE中患有RVD的患者，成为超声心动图的辅助工具。BNP或NT-proBNP水平升高也是APE患者死亡和/或复杂临床病程的重要预测指标。
