Yamazaki Mayuko, Ogawa Tetsuya, Tamei Noriko, Ando Yoshitaka, Nitta Kosaku
Department of Medicine, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan.
Heart Vessels. 2011 Jul;26(4):421-7. doi: 10.1007/s00380-010-0066-4. Epub 2010 Dec 3.
Cardiovascular disease is the major cause of death in hemodialysis (HD) patients. We investigated the relation of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and left atrial volume index (LAVi) to left ventricular function in chronic HD patients. A total of 117 patients were enrolled as subjects (74 men and 43 women). Echocardiography was performed to evaluate the left atrial volume index (LAVi) and left ventricular mass index (LVMI). Diastolic left ventricular function was estimated as E/E' by tissue Doppler imaging with cardiac ultrasonography. Serum NT-proBNP was measured at the time of echocardiographic measurements. Multiple regression analysis showed that LAVi (F = 24.372, p < 0.0001) and E/E' (F = 23.473, p < 0.0116) were significant predictors for serum NT-proBNP levels, and LVMI (F = 46.807, p < 0.0001) was a best predictor for LAVi among associated factors. These findings suggest that serum NT-proBNP and LAVi are both good biomarkers for predicting the LV remodeling in chronic HD patients.
心血管疾病是血液透析(HD)患者的主要死因。我们研究了慢性HD患者中N端前脑钠肽(NT-proBNP)和左心房容积指数(LAVi)与左心室功能的关系。共纳入117例患者作为研究对象(74例男性和43例女性)。进行超声心动图检查以评估左心房容积指数(LAVi)和左心室质量指数(LVMI)。通过心脏超声心动图的组织多普勒成像将舒张期左心室功能评估为E/E'。在进行超声心动图测量时检测血清NT-proBNP。多元回归分析显示,LAVi(F = 24.372,p < 0.0001)和E/E'(F = 23.473,p < 0.0116)是血清NT-proBNP水平的显著预测指标,而LVMI(F = 46.807,p < 0.0001)是相关因素中LAVi的最佳预测指标。这些发现表明,血清NT-proBNP和LAVi都是预测慢性HD患者左心室重构的良好生物标志物。