脑钠肽作为主动脉瓣狭窄患者左心室肥厚的标志物。

Brain natriuretic peptide as a marker of left ventricular hypertrophy in patients with aortic stenosis.

作者信息

Orlowska-Baranowska Ewa, Baranowski Rafal, Greszata Lidia, Stepinska Janina

机构信息

Department of Valvular Heart Diseases, National Institute of Cardiology, Warszawa, Poland.

出版信息

J Heart Valve Dis. 2008 Nov;17(6):598-605.

PMID:19137789

Abstract

BACKGROUND AND AIM OF THE STUDY

In aortic stenosis (AS), serum levels of brain natriuretic peptide (BNP) are elevated, but the relation of this elevation to the degree of left ventricular hypertrophy (LVH) remains unclear. The study aim was to assess the relationship between BNP and LVH (expressed as LV mass index, LVMI) and LV wall thickness index (WThI) in a group of patients.

METHODS

A total of 147 patients with AS (85 men, 62 women; mean age 61 +/- 12 years) each underwent echocardiography and serum BNP analysis. The correlation between serum BNP level and LVH was investigated, with patient gender, age, NYHA class, AS severity and presence of coronary artery disease also being taken into account.

RESULTS

Among AS patients, serum BNP levels ranged from 3 to 2010 pg/ml; mean BNP levels were similar in women and men (213 +/- 302 and 253 +/- 375 pg/ml, respectively). The BNP level also correlated directly with the LVMI (r = 0.55; p <0.0001), WThI (r = 0.26; p <0.001), end-diastolic dimension (r = 0.43; p <0.0001), mean aortic gradient (r = 0.25; p = 0.002), age (r = 0.27; p = 0.001); and correlated inversely with the LV ejection fraction (r = -0.52; p <0.0001). Eccentric LVH was associated with a significantly higher serum BNP level (506 +/- 558 pg/ml) than concentric-type hypertrophy (190 +/- 254 pg/ml; p = 0.002).

CONCLUSION

The measurement of serum BNP levels is of potential value when monitoring LVH in aortic stenosis patients.

摘要

研究背景与目的

在主动脉瓣狭窄（AS）患者中，血清脑钠肽（BNP）水平升高，但这种升高与左心室肥厚（LVH）程度的关系尚不清楚。本研究的目的是评估一组患者中BNP与LVH（以左心室质量指数，LVMI表示）和左心室壁厚度指数（WThI）之间的关系。

方法

共有147例AS患者（85例男性，62例女性；平均年龄61±12岁）接受了超声心动图检查和血清BNP分析。研究了血清BNP水平与LVH之间的相关性，同时考虑了患者的性别、年龄、纽约心脏协会（NYHA）心功能分级、AS严重程度以及冠状动脉疾病的存在情况。

结果

在AS患者中，血清BNP水平范围为3至2010 pg/ml；女性和男性的平均BNP水平相似（分别为213±302和253±375 pg/ml）。BNP水平还与LVMI（r = 0.55；p <0.0001）、WThI（r = 0.26；p <0.001）、舒张末期内径（r = 0.43；p <0.0001）、平均主动脉瓣压差（r = 0.25；p = 0.002）、年龄（r = 0.27；p = 0.001）呈正相关；与左心室射血分数（r = -0.52；p <0.0001）呈负相关。与向心性肥厚（190±254 pg/ml；p = 0.002）相比，离心性LVH患者的血清BNP水平显著更高（506±558 pg/ml）。