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先天性心脏病继发肺动脉高压患儿左心室舒张功能与血浆利钠肽水平的相关性

[Correlation between left ventricular diastolic function and plasma natriuretic peptide level in children with pulmonary artery hypertension secondary to congenital heart disease].

作者信息

Cui Hua, Hu Yi-Xin, Feng Zhi-Chun

机构信息

Second Department of Cardiology, General Hospital of People's Liberation Army, Beijing 100853, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2010 Jan;12(1):13-6.

Abstract

OBJECTIVE

To study the plasma natriuretic peptide (BNP) level in children with pulmonary artery hypertension (PAH) secondary to congenital heart disease (CHD) and its correlation with left ventricular diastolic function.

METHODS

Doppler echocardiography was performed on 95 CHD children with PAH (PAH group) and on 42 CHD without PAH (control group). The plasma BNP level was measured using radioimmunity assay.

RESULTS

Doppler echocardiography showed that the left ventricular end-diastolic diameter (LVDd), the right ventricular diameter end-diastolic (RVDd), and the pulmonary artery diameter (PAd) increased significantly in the PAH group compared with those in the control group (p<0.05). The PAH group had higher velocity of tricuspid regurgitation (VTR) and higher pulmonary artery systolic pressure (PASP) than the control group (p<0.05). The PAH group also had higher mitral A peak velocity (AV), higher mitral A peak velocity integral (AVI), higher E peak velocity intgral (EVI), and higher ratio of mitral AV to mitral E peak velocity (EV) and AVI/EVI ratio as well as prolonged left ventricular volumetric relaxation time than the control group. PASP was positively correlated with the AV/EV ratio (p<0.05). The plasma BNP level in the PAH group increased significantly compared with that in the control group. In the PAH group, the plasma BNP level was positively correlated with the pulmonary artery pressure and the ratio of AV/EV.

CONCLUSIONS

The left ventricular diastolic function is positively correlated with the plasma BNP level in children with PAH secondary to CHD. BNP may play an important role in the generation and development of left ventricular diastolic dysfunction induced by PAH.

摘要

目的

研究先天性心脏病(CHD)继发肺动脉高压(PAH)患儿的血浆脑钠肽(BNP)水平及其与左心室舒张功能的相关性。

方法

对95例CHD合并PAH患儿(PAH组)和42例无PAH的CHD患儿(对照组)进行多普勒超声心动图检查。采用放射免疫分析法测定血浆BNP水平。

结果

多普勒超声心动图显示,与对照组相比,PAH组的左心室舒张末期内径(LVDd)、右心室舒张末期内径(RVDd)和肺动脉内径(PAd)显著增加(p<0.05)。PAH组的三尖瓣反流速度(VTR)和肺动脉收缩压(PASP)高于对照组(p<0.05)。PAH组的二尖瓣A峰速度(AV)、二尖瓣A峰速度积分(AVI)、E峰速度积分(EVI)、二尖瓣AV与二尖瓣E峰速度比值(EV)以及AVI/EVI比值也高于对照组,且左心室容积舒张时间延长。PASP与AV/EV比值呈正相关(p<0.05)。PAH组的血浆BNP水平较对照组显著升高。在PAH组中,血浆BNP水平与肺动脉压力和AV/EV比值呈正相关。

结论

CHD继发PAH患儿的左心室舒张功能与血浆BNP水平呈正相关。BNP可能在PAH所致左心室舒张功能障碍的发生和发展中起重要作用。

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