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NT-proBNP 可预测射血分数保留的新发高血压患者心肌功能受损。

NT-proBNP predicts impaired myocardial function in newly diagnosed hypertensive patients with preserved ejection fraction.

机构信息

Department of Cardiology and.

出版信息

Clin Exp Hypertens. 2014;36(5):289-94. doi: 10.3109/10641963.2013.810234. Epub 2013 Jul 18.

Abstract

N-terminal pro-brain natriuretic peptide (NT-proBNP) is an excellent biomarker to diagnose left ventricular (LV) dysfunction. LV myocardial performance index (MPI-Tei index) is commonly used as a measure of combined systolic and diastolic function. We aimed to investigate the relationship between NT-proBNP and tissue Doppler derived MPI in newly diagnosed hypertensive patients with preserved LV ejection fraction (LVEF). We studied 236 patients with newly diagnosed HT (mean age; 52.9 ± 5.2 years). Echocardiographic examination was performed in all patients. LV mass index (LVMI) was calculated. Conventional Doppler indices (E and A waves) were recorded. The MPI value was obtained from the tissue Doppler derived ejection time, isovolumic contraction and relaxation times. The patients were divided into two groups according to the median NT-proBNP value (NT-proBNPlow group <114 pg/ml and NT-proBNPhigh group ≥114 pg/ml). Patients with NT-proBNPhigh were older and had higher levels of glucose and creatinine, lower E/A ratio and higher LVMI and MPI values than patients with NT-proBNPlow. However, LVEF were similar among the groups. Multiple linear regression analysis showed that NT-proBNP was independently associated with age, LVMI, MPI and E/A ratio. Increased NT-proBNP level was independently associated with impaired myocardial performance index in newly diagnosed hypertensive patients with preserved LVEF.

摘要

N 端脑利钠肽前体(NT-proBNP)是诊断左心室(LV)功能障碍的优秀生物标志物。LV 心肌性能指数(MPI-Tei 指数)通常用作收缩和舒张功能综合的测量指标。我们旨在研究新诊断的 LV 射血分数(LVEF)正常的高血压患者中 NT-proBNP 与组织多普勒衍生的 MPI 之间的关系。我们研究了 236 名新诊断的 HT 患者(平均年龄 52.9±5.2 岁)。所有患者均进行了超声心动图检查。计算 LV 质量指数(LVMI)。记录常规多普勒指数(E 和 A 波)。MPI 值是从组织多普勒衍生的射血时间、等容收缩和舒张时间获得的。根据 NT-proBNP 的中位数将患者分为两组(NT-proBNPlow 组 <114pg/ml 和 NT-proBNPhigh 组 ≥114pg/ml)。NT-proBNPhigh 组的患者年龄较大,血糖和肌酐水平较高,E/A 比值较低,LVMI 和 MPI 值较高,而 NT-proBNPlow 组的患者则相反。然而,各组之间的 LVEF 相似。多元线性回归分析显示,NT-proBNP 与年龄、LVMI、MPI 和 E/A 比值独立相关。在新诊断的 LVEF 正常的高血压患者中,NT-proBNP 水平升高与心肌性能指数受损独立相关。

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