Cardiovascular Rehabilitation-Heart Failure Unit, SS. Trinità Hospital, Via Ospedale 4, 12045 Fossano, Italy.
J Endocrinol Invest. 2010 Sep;33(8):554-8. doi: 10.1007/BF03346647. Epub 2010 Feb 15.
This study compared two different methods, namely the immunoradiometric (IRMA) and fluorimetric (FIA), in order to determine plasma brain natriuretic peptide (BNP) in congestive heart failure (CHF) patients.
CHF in-patients underwent echocardiography and plasma BNP determination using both two methods. The echocardiograms analysed left ventricular end-systolic (LVESV) and end-diastolic (LVEDV) volumes and systolic dysfunction [left ventricular ejection fraction (LVEF) <50%].
Seventy-three (71% males, age 67 ± 9.6 yr) patients were enrolled, 31.5% affected by valvular heart disease. The mean LVEF was 39.8 ± 14.1%; in 26 (35%) a hypertensive etiology emerged. The immunoradiometric assay (IRMA) BNP was found to be significantly lower than the FIA determination 116.5 ± 149 pg/ml vs 267.3 ± 285.6 pg/ml; p=0.0001) and the two methods were closely correlated (r=0.89; p=0.00001). Logistic regression demonstrated a significant correlation between BNP, LVEF, and LVESV/LVEDV (r=-0.45, p=0.0003; r=-0.48, p=0.00001; r=0.22 p=0.003; r=0.34 p=0.0001; r=0.13 p=0.02; r=0.28 p=0.001 IRMA and FIA, respectively). IRMA BNP and FIA BNP significantly increased according to the worsening functional class [from 34.3 ± 60.2 pg/ml in NYHA (New York Heart Association) I to 555.5 ± 273.1 pg/ml in NYHA IV; from 86.1 ± 162.1 pg/ml in NYHA I to 1070 ± 42.2 pg/ml in NYHA IV, respectively]. In severe systolic dysfunction (LVEF<30%), receiver operating characteristic analysis revealed a satisfactorily sensitivity and specificity using a cut-off point of 50.6 pg/ml with IRMA and 243 pg/ml with FIA. In mild systolic dysfunction (LVEF<50%), a good sensitivity and specificity using a cut-off point of 42 pg/ml with IRMA and 182 pg/ml with FIA emerged.
In CHF patients both BNP methods correlated with NYHA class, LVEF, and ventricular volumes.
比较两种不同方法，即免疫放射分析（IRMA）和荧光免疫分析（FIA），以确定充血性心力衰竭（CHF）患者的血浆脑利钠肽（BNP）。
CHF 住院患者接受了两种方法的超声心动图和血浆 BNP 检测。超声心动图分析了左心室收缩末期（LVESV）和舒张末期（LVEDV）容积和收缩功能障碍[左心室射血分数（LVEF）<50%]。
共纳入 73 例（71%为男性，年龄 67±9.6 岁）患者，31.5%患有瓣膜性心脏病。平均 LVEF 为 39.8±14.1%；26 例（35%）出现高血压病因。IRMA BNP 明显低于 FIA 测定值 116.5±149pg/ml 与 267.3±285.6pg/ml；p=0.0001），两种方法密切相关（r=0.89；p=0.00001）。Logistic 回归显示 BNP、LVEF 和 LVESV/LVEDV 之间存在显著相关性（r=-0.45，p=0.0003；r=-0.48，p=0.00001；r=0.22，p=0.003；r=0.34，p=0.0001；r=0.13，p=0.02；r=0.28，p=0.001，IRMA 和 FIA 分别）。IRMA BNP 和 FIA BNP 随着功能分级的恶化而显著增加[从 NYHA（纽约心脏协会）I 期的 34.3±60.2pg/ml 到 NYHA IV 期的 555.5±273.1pg/ml；从 NYHA I 期的 86.1±162.1pg/ml 到 NYHA IV 期的 1070±42.2pg/ml]。在严重收缩功能障碍（LVEF<30%）中，使用 IRMA 的 50.6pg/ml 和 FIA 的 243pg/ml 作为截断值的受试者工作特征分析显示出较好的灵敏度和特异性。在轻度收缩功能障碍（LVEF<50%）中，IRMA 的 42pg/ml 和 FIA 的 182pg/ml 作为截断值显示出良好的灵敏度和特异性。
在 CHF 患者中，两种 BNP 方法均与 NYHA 分级、LVEF 和心室容积相关。
