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NT-脑钠肽水平与左心室壁应力、球形指数及心肌损伤程度的相关性:一项磁共振成像研究

Correlation Between NT-pro BNP levels and left ventricular wall stress, sphericity index and extent of myocardial damage: a magnetic resonance imaging study.

作者信息

Krittayaphong Rungroj, Boonyasirinant Thananya, Saiviroonporn Pairash, Thanapiboonpol Prajak, Nakyen Supaporn, Udompunturak Suthipol

机构信息

Department of Medicine, Division of Cardiology, Siriraj Hospital, Bangkok, Thailand.

出版信息

J Card Fail. 2008 Oct;14(8):687-94. doi: 10.1016/j.cardfail.2008.05.002. Epub 2008 Jun 11.

Abstract

BACKGROUND

To determine the relationship between N-terminal pro-brain natriuretic peptide (NT-pro BNP) levels and left ventricular wall stress, sphericity index, function, and extent of myocardial damage in patients with coronary artery disease and abnormal left ventricular wall motion.

METHODS AND RESULTS

All patients underwent cardiac magnetic resonance imaging (CMR). Measurements of sphericity index and wall stress were performed. Percentages of myocardial scarring were calculated from delayed-enhancement images. Correlations between log NT-pro BNP levels and various parameters were evaluated. There were 125 patients with an average age of 62.6 +/- 9.6 years. Median levels of NT-proBNP were 1012 pg/mL. Average left ventricular ejection fraction (LVEF) was 37 +/- 14.4%. Log NT-proBNP levels had positive correlations with wall stress, sphericity index, left ventricular dimension, volume, mass, wall motion score, extent of myocardial scarring, and age, and had negative correlations with creatinine clearance, LVEF, stroke volume, and body size. Multiple linear regression analysis showed that diastolic and systolic wall stress and systolic sphericity index were independent predictors for log NT-proBNP levels.

CONCLUSIONS

NT-proBNP levels strongly correlated with left ventricular wall stress and moderately correlated with sphericity index.

摘要

背景

确定冠心病伴左心室壁运动异常患者中N末端前脑钠肽(NT-pro BNP)水平与左心室壁应力、球形指数、功能及心肌损伤程度之间的关系。

方法与结果

所有患者均接受心脏磁共振成像(CMR)检查。进行球形指数和壁应力测量。根据延迟强化图像计算心肌瘢痕形成百分比。评估log NT-pro BNP水平与各项参数之间的相关性。共有125例患者,平均年龄为62.6±9.6岁。NT-proBNP的中位数水平为1012 pg/mL。平均左心室射血分数(LVEF)为37±14.4%。log NT-proBNP水平与壁应力、球形指数、左心室尺寸、容积、质量、壁运动评分、心肌瘢痕形成程度及年龄呈正相关,与肌酐清除率、LVEF、每搏输出量及体型呈负相关。多元线性回归分析显示,舒张期和收缩期壁应力以及收缩期球形指数是log NT-proBNP水平的独立预测因素。

结论

NT-proBNP水平与左心室壁应力密切相关,与球形指数中度相关。

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