Neumann Till, Reinsch Nico, Neuhaus Kathrin, Brockmeyer Norbert, Potthoff Anja, Esser Stefan, Hower Martin, Neumann Anja, Mostardt Sarah, Gelbrich Götz, Erbel Raimund
Klinik für Kardiologie, Zentrum für Innere Medizin, Universitätsklinikum, Essen, Germany.
Herz. 2009 Dec;34(8):634-40. doi: 10.1007/s00059-009-3313-7.
HIV-infected patients exhibit an increased rate of cardiac diseases, due to an elevated rate of cardiac risk factors and side effects of antiretroviral therapy. The aim of the present study was to analyze the impact of B-type natriuretic peptide (BNP) in this patient population.
The HIV-HEART (HIV infection and HEART disease) study is a prospective and multicenter cohort study. Outpatients with a known HIV infection were included over a 20-month recruiting period. BNP values were determined by a standardized laboratory test at study inclusion.
802 HIV-infected patients (male: 83.4%, mean age: 44.2 +/- 10.3 years) were included. The BNP concentrations (median 11.3 pg/ml; BNP < or = 100 pg/ml: 96.2%) were associated with echocardiographic parameters and with the right ventricular diameter (p = 0.02) and the systolic pulmonary arterial pressure (p = 0.01). Patients with a BNP concentration of > 50 pg/ml had a significantly higher rate of heart failure (p < 0.001), cardiomyopathy (p < 0.001), and coronary artery disease (p < 0.001).
The data demonstrate that BNP is suitable for the detection of cardiac disorders in HIV-infected subjects. Therefore, BNP could be an appropriate tool for a screening program for HIV-associated disorders in this patient population.
由于心脏危险因素发生率升高以及抗逆转录病毒疗法的副作用,HIV感染患者患心脏病的几率增加。本研究的目的是分析B型利钠肽(BNP)在该患者群体中的影响。
HIV-HEART(HIV感染与心脏病)研究是一项前瞻性多中心队列研究。在为期20个月的招募期内纳入了已知感染HIV的门诊患者。在研究纳入时通过标准化实验室检测确定BNP值。
纳入了802例HIV感染患者(男性:83.4%,平均年龄:44.2±10.3岁)。BNP浓度(中位数11.3 pg/ml;BNP≤100 pg/ml:96.2%)与超声心动图参数以及右心室直径(p = 0.02)和收缩期肺动脉压(p = 0.01)相关。BNP浓度>50 pg/ml的患者心力衰竭(p < 0.001)、心肌病(p < 0.001)和冠状动脉疾病(p < 0.001)的发生率显著更高。
数据表明BNP适用于检测HIV感染受试者的心脏疾病。因此,BNP可能是该患者群体中HIV相关疾病筛查项目的合适工具。