心力衰竭患者胸腔液含量与脑钠肽 B 型之间的关系。

Relationship between thoracic fluid content and natriuretic peptide type B in patients with systolic heart failure.

机构信息

2nd Department of Cardiology, Collegium Medicum, Bydgoszcz, The Mikołaj Kopernik University in Torun, Poland.

出版信息

Kardiol Pol. 2009 Nov;67(11):1220-5.

PMID:20024849

Abstract

BACKGROUND

Thoracic fluid content (TFC) is one of the basic parameters measured by impedance cardiography (ICG). The B-type natriuretic peptide (BNP) is a neuroendocrine mediator produced in the ventricular myocardium and released in response to the increase of wall tension.

AIM

To determine the relationship between TFC measured by ICG and BNP serum level in patients with systolic heart failure (HF).

METHODS

The study population included 50 patients: a group of 30 patients with systolic HF in functional NYHA class II and III [27 males and 3 females, aged 53 +/- 6 years, with mean left ventricular ejection fraction (LVEF) 23 +/- 6%], and 20 controls without HF symptoms and preserved LVEF. The TFC and BNP serum level were measured on the same day.

RESULTS

Mean BNP serum concentration was 521 +/- 882 pg/ml in HF patients and 44 +/- 36 pg/ml in healthy controls (p = 0.02). The TFC values did not differ significantly between the two groups (27.3 +/- 4.5 1/kW in the study group versus 26.3 +/- 2.8 1/kW in control subjects, NS). A significant correlation between TFC and BNP was found in patients with overt HF (r = 0.57, p = 0.001); however, after excluding one patient with exacerbation of HF symptoms, the correlation was non-significant (r = 0.24, p = 0.22). No correlation between these parameters was observed in healthy controls (r = 0.17, p = 0.51).

CONCLUSIONS

There was no significant correlation between TFC measured by ICG and BNP serum level in haemodynamically stable patients with HF symptoms. The usefulness of ICG measurements in patients with exacerbated chronic HF needs further investigations.

摘要

背景

胸腔液含量（TFC）是阻抗心动图（ICG）测量的基本参数之一。B 型利钠肽（BNP）是一种在心室心肌中产生的神经内分泌介质，在壁张力增加时释放。

目的

确定 ICG 测量的 TFC 与收缩性心力衰竭（HF）患者血清 BNP 水平之间的关系。

方法

研究人群包括 50 名患者：一组 30 名有收缩性 HF 的患者，NYHA 心功能 II 级和 III 级（27 名男性和 3 名女性，年龄 53 ± 6 岁，平均左心室射血分数（LVEF）为 23 ± 6%），和 20 名无 HF 症状和保留 LVEF 的对照者。同一天测量 TFC 和 BNP 血清水平。

结果

HF 患者的平均 BNP 血清浓度为 521 ± 882 pg/ml，健康对照组为 44 ± 36 pg/ml（p = 0.02）。两组 TFC 值无显著差异（研究组 27.3 ± 4.5 1/kW，对照组 26.3 ± 2.8 1/kW，NS）。在有明显 HF 患者中，TFC 与 BNP 之间存在显著相关性（r = 0.57，p = 0.001）；然而，排除 1 例 HF 症状恶化的患者后，相关性无统计学意义（r = 0.24，p = 0.22）。在健康对照组中，这些参数之间无相关性（r = 0.17，p = 0.51）。