Department of Clinical Functional Physiology, Toho University Medical Center Omori Hospital, Tokyo, Japan.
J Cardiol. 2010 Jul;56(1):91-6. doi: 10.1016/j.jjcc.2010.03.003. Epub 2010 May 5.
B-type natriuretic peptide (BNP) has been used widely as an objective marker for severity and prognostic predictor of heart failure. Recently it has been reported that plasma BNP level is associated with left ventricular (LV) diastolic dysfunction. Color kinesis (CK), a technique based on acoustic quantification, has been developed to facilitate the evaluation of regional wall motion and LV function. The aim of this study is to investigate the relationship between plasma BNP levels and LV diastolic function using diastolic CK imaging.
The study included 65 subjects in sinus rhythm who were referred for echocardiography to evaluate cardiac function with simultaneous measurements of plasma BNP. Thirty-five patients were in New York Heart Association class I or II, and 15 were in class III or IV. We performed echocardiography with assessment of LV function, including LV ejection fraction (EF), transmitral flow (E/A), early diastolic mitral annular velocity (e'), and diastolic CK. Diastolic CK images, obtained from LV mid-papillary short-axis view, were analyzed using ICK software. The CK-diastolic index (CK-DI) was defined as the calculated LV segmental filling fraction during the first 30% of diastole, expressed as a percentage. The mean CK-DI was determined from the average CK-DI of six segments (anterior, anteroseptal, septal, inferior, posterior, lateral wall). Blood for BNP was collected on the same day as the echocardiographic study. We found significant correlations between mean CK-DI and log BNP (r=-0.66, p<0.0001), whereas log BNP correlated weakly with EF (r=-0.26), E/A (r=0.22), DT (r=-0.15) and E/e' (r=0.41).
Our results suggest that the plasma BNP level may be related to LV relaxation. The analysis of diastolic CK may be useful for quantitative assessment of LV diastolic function in patients with heart failure.
B 型利钠肽（BNP）已被广泛用作心力衰竭严重程度和预后预测的客观标志物。最近有报道称，血浆 BNP 水平与左心室（LV）舒张功能障碍有关。彩色运动（CK）是一种基于声学定量的技术，已经被开发出来，以方便评估局部壁运动和 LV 功能。本研究旨在通过舒张期 CK 成像研究血浆 BNP 水平与 LV 舒张功能的关系。
该研究纳入了 65 名窦性节律患者，他们因评估心脏功能而行超声心动图检查，并同时测量血浆 BNP。35 例患者为纽约心脏协会（NYHA）I 级或 II 级，15 例为 III 级或 IV 级。我们进行了超声心动图检查，评估 LV 功能，包括 LV 射血分数（EF）、二尖瓣前向血流（E/A）、舒张早期二尖瓣环速度（e'）和舒张期 CK。从 LV 中部乳头肌短轴切面获得舒张期 CK 图像，并用 ICK 软件进行分析。CK 舒张指数（CK-DI）定义为舒张早期 30%时计算的 LV 节段充盈分数，以百分比表示。CK-DI 平均值由 6 个节段（前壁、前间隔、间隔、下壁、后壁、侧壁）的平均 CK-DI 确定。BNP 血液采集于超声心动图研究同日进行。我们发现平均 CK-DI 与 log BNP 呈显著相关（r=-0.66，p<0.0001），而 log BNP 与 EF（r=-0.26）、E/A（r=0.22）、DT（r=-0.15）和 E/e'（r=0.41）相关性较弱。
我们的结果表明，血浆 BNP 水平可能与 LV 松弛有关。舒张期 CK 的分析可能有助于心力衰竭患者 LV 舒张功能的定量评估。
