N 端脑利钠肽前体可预测左心室肥厚患者的死亡率。

N-terminal pro B-type natriuretic peptide predicts mortality in patients with left ventricular hypertrophy.

机构信息

Department of Medicine, Cardiology Section, University of Minnesota, Minneapolis, Minnesota, United States.

出版信息

Int J Cardiol. 2010 Sep 3;143(3):349-52. doi: 10.1016/j.ijcard.2009.03.070. Epub 2009 Apr 7.

DOI:10.1016/j.ijcard.2009.03.070

PMID:19356808

Abstract

BACKGROUND

Left ventricular hypertrophy adversely affects outcomes in patients with hypertension. Whether N-terminal pro B-type natriuretic peptide (NT-proBNP) adds incremental prognostic information in patients with hypertension and left ventricular hypertrophy (LVH) is not well established. We aimed to study the prognostic value of NT-proBNP in hypertensive patients with LVH.

METHODS

Echocardiography was performed in 232 patients (mean age 61±15, 102 males, 130 females) for the diagnosis of left ventricular hypertrophy. Left ventricular mass was measured according to The American Society of Echocardiography guidelines. A blood sample was taken for NT-proBNP determination. NT-proBNP levels were analyzed in quartiles after log transformation. Long term survival was established by review of electronic medical records.

RESULTS

Arterial hypertension was present in 130 patients (56%) and left ventricular hypertrophy was present in 105 patients (45%). In patients with left ventricular hypertrophy, NT-proBNP levels predicted long term survival (Chi-square=10, p=0.01). After adjusting by age, presence of coronary artery disease, ejection fraction, diabetes status, and hypertension; patients in highest NT pro-BNP quartile were twice as likely to die when compared to patients in the lowest NT-ptoBNP quartile (OR=2.2, 95% CI=1.0-4.6, p=0.03).

CONCLUSION

NT-proBNP is an independent predictor of survival in patients with hypertension and increased left ventricular mass.

摘要

背景

左心室肥厚会对高血压患者的预后产生不利影响。N 末端脑钠肽前体（NT-proBNP）是否能为高血压合并左心室肥厚（LVH）患者提供额外的预后信息尚未得到充分证实。我们旨在研究 NT-proBNP 在高血压合并 LVH 患者中的预后价值。

方法

对 232 名患者（平均年龄 61±15 岁，102 名男性，130 名女性）进行超声心动图检查以诊断左心室肥厚。根据美国超声心动图学会指南测量左心室质量。采集血样检测 NT-proBNP。对 NT-proBNP 水平进行对数转换后进行四分位分析。通过电子病历回顾确定长期生存情况。

结果

130 名患者（56%）存在高血压，105 名患者（45%）存在左心室肥厚。在存在左心室肥厚的患者中，NT-proBNP 水平预测长期生存（卡方=10，p=0.01）。在调整年龄、冠状动脉疾病、射血分数、糖尿病状态和高血压后；与 NT-ptoBNP 四分位数最低的患者相比，NT-proBNP 四分位数最高的患者死亡的可能性是其两倍（OR=2.2，95%CI=1.0-4.6，p=0.03）。