Parakh Neeraj, Mehrotra Sameer, Seth Sandeep, Ramakrishnan S, Kothari Shyam S, Bhargava Balram, Bahl V K
Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India.
Division of Cardiology, Medanta the Medicity, Gurgaon, India.
Indian Heart J. 2015 Jan-Feb;67(1):40-4. doi: 10.1016/j.ihj.2015.02.008. Epub 2015 Mar 13.
The differentiation of constrictive pericarditis (CP) from restrictive cardiomyopathy (RCM) may be clinically difficult and may require multiple investigations. Even though brain natriuretic peptide (BNP) is shown to be higher in patients with RCM as compared to CP, the clinical utility is not fully established especially in Indian patients known to have advanced CP and myocardial involvement.
We measured NT-pro-BNP levels in 49 patients suspected of having either CP or RCM, diagnosed on the basis of echocardiography, computed tomography, magnetic resonance imaging, endomyocardial biopsy and cardiac catheterization data as needed. Twenty nine patients (Mean age - 26 yrs, 24 males) had CP and 20 patients (Mean age - 39 yrs, 14 males) had RCM. The median plasma NT-pro-BNP levels were significantly higher in RCM as compared to CP [1775 (208-7500) pg/ml vs 124 (68-718) pg/ml, respectively; p = 0.001]. A cut off value of 459 pg/ml had sensitivity, specificity and overall accuracy of 90%, 86% and 88% respectively, for differentiating CP from RCM.
The NT-pro-BNP levels are significantly elevated in RCM as compared to CP.
缩窄性心包炎（CP）与限制型心肌病（RCM）的鉴别在临床上可能存在困难，可能需要多项检查。尽管脑钠肽（BNP）在RCM患者中显示比CP患者更高，但临床应用尚未完全确立，尤其是在已知患有晚期CP和心肌受累的印度患者中。
我们测量了49例疑似患有CP或RCM患者的NT-pro-BNP水平，这些患者根据需要通过超声心动图、计算机断层扫描、磁共振成像、心内膜心肌活检和心导管检查数据进行诊断。29例患者（平均年龄 - 26岁，24例男性）患有CP，20例患者（平均年龄 - 39岁，14例男性）患有RCM。与CP相比，RCM患者的血浆NT-pro-BNP中位数水平显著更高[分别为1775（208 - 7500）pg/ml和124（68 - 718）pg/ml；p = 0.001]。459 pg/ml的截断值在区分CP和RCM时，敏感性、特异性和总体准确率分别为90%、86%和88%。
与CP相比，RCM患者的NT-pro-BNP水平显著升高。
