[Application value of combining brain natriuretic peptide, creatine phosphokinase and echocardiogram in the evaluation of polymyositis-related chronic heart failure].

OBJECTIVE

To explore the application value of combining brain natriuretic peptide (BNP), creatine phosphokinase (CPK) and echocardiogram in the evaluation of olymyositis-related chronic heart failure (CHF).

METHODS

Twenty-five polymyositis (PM) patients with CHF (NYHA grade II-IV) were evaluated with New York Heart Association (NYHA) criteria for heart failure. Serum concentration of BNP and CPK were detected by the methods of enzyme linked immunosorbent assay and automatic biochemistry analyzer respectively. Echocardiogram was used to calculate left ventricular ejection fraction (LVEF). Thirty PM patients without CHF were also investiaged as control.

RESULTS

Serum concentrations of BNP, CPK in PM with CHF were significantly higher than those in PM without CHF (P < 0.01). Compared with the level before intervention, BNP concentration in PM with CHF decreased sharply after 14 days therapy (P < 0.05), while the decrease of BNP concentration was not statistically significant (P > 0.05) in PM without CHF after the therapy. The concentration of CPK was much lower in PM patients either with or without CHF after therapy (P < 0.05). Among each group of NYHA grade II-IV, there was statistical significant difference of BNP concentration (P < 0.05). Statistical significant difference of CPK concentration was only found between grade II and grade IV patients. The difference of BNP was not statistical significant between PM patients without CHF but CPK > 2 000 IU/L and PM with grade II CHF. BNP concentration was significantly different between PM patients with LVEF > 40% and those with LVEF < or = 40% (P < 0.05).

CONCLUSION

BNP is a good marker for PM with CHF and correlates well with LVEF and NYHA grades. In addition, it plays a suggestive role in diagnosing CHF in PM with CPK > 2 000 IU/L.