Department of Cardiology, Cardiovascular Center, University Hospital Zurich, Zurich, Switzerland.
Clin Cardiol. 2011 Mar;34(3):183-8. doi: 10.1002/clc.20894.
Outpatients frequently present with elevated natriuretic peptides in the absence of an obvious cardiac abnormality or with normal natriuretic peptides despite echocardiographic findings.
We aimed to determine the prognostic value of N-terminal pro B-type natriuretic peptide (NTpBNP) in outpatients with normal and abnormal echocardiography.
A total of 433 cardiovascular outpatients were included. The prognostic value of NTpBNP in patients with normal and abnormal echocardiography during a 2-year follow-up was evaluated.
Patients with abnormal echocardiography and elevated NTpBNP had a mortality rate of 8.7% and an overall event rate of 20.2% (composite end point of overall mortality, myocardial infarction, and hospitalization for heart failure), which was significantly higher than in patients with abnormal echocardiography and normal NTpBNP, in which no mortality (P=0.011) and no events were observed (P<0.001). In patients with a normal echocardiography, mortality was 1.5% and 1.8% for patients with normal and elevated NTpBNP, respectively (P=1.000). Composite event rate was 1.5% and 8.9% (P=0.093), respectively.
Patients with low NTpBNP have an excellent prognosis irrespective of echocardiographic findings. Therefore, determination of NTpBNP appears useful in assessing the clinical relevance of echocardiographic findings.
门诊患者常出现利钠肽升高，但无明显心脏异常，或超声心动图正常而利钠肽正常。
我们旨在确定 N 末端 B 型利钠肽原（NTpBNP）在超声心动图正常和异常的门诊患者中的预后价值。
共纳入 433 例心血管门诊患者。评估了 2 年随访期间 NTpBNP 在超声心动图正常和异常患者中的预后价值。
超声心动图异常和 NTpBNP 升高的患者死亡率为 8.7%，总事件发生率为 20.2%（总死亡率、心肌梗死和心力衰竭住院的复合终点），明显高于超声心动图异常和 NTpBNP 正常的患者，后者未观察到死亡率（P=0.011）和事件（P<0.001）。在超声心动图正常的患者中，NTpBNP 正常和升高的患者死亡率分别为 1.5%和 1.8%（P=1.000）。复合事件发生率分别为 1.5%和 8.9%（P=0.093）。
无论超声心动图结果如何，NTpBNP 水平低的患者预后均良好。因此，测定 NTpBNP 似乎有助于评估超声心动图结果的临床意义。
