Plas Gerben J J, Jurg Susanne D, Brusse-Keizer Marjolein, Dippel Diederik W J, Koudstaal Peter J, den Hertog Heleen M
Department of Neurology, Medical Spectrum Twente, Enschede, The Netherlands (G.J.P., S.D.J., H.M.H.).
Medical School Twente, Medical Spectrum Twente, Enschede, The Netherlands (M.B.K.).
J Am Heart Assoc. 2015 Dec 15;4(12):e002072. doi: 10.1161/JAHA.115.002072.
Transient nonfocal neurological symptoms may serve as markers of cardiac dysfunction. We assessed whether serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, a biomarker of cardiac disease, are increased in patients with transient ischemic attack (TIA) accompanied by nonfocal symptoms and in patients with attacks of nonfocal symptoms (transient neurological attack [TNA]).
We included 15 patients with TNA, 69 with TIA accompanied by nonfocal symptoms, 58 with large-vessel TIA, 32 with cardioembolic TIA, and 46 age- and sex-matched healthy control participants. Serum NT-proBNP levels were determined within 1 week after the attack. We compared log-transformed NT-proBNP levels of patients with cardioembolic TIAs and mixed or nonfocal TNAs, with those of patients with noncardioembolic TIAs as a reference group. Adjustments for age, sex, atrial fibrillation, and a history of nonischemic heart disease were made with a multiple linear regression model. Compared with large-vessel TIA (mean 14.2 pmol/L), mean NT-proBNP levels were significantly higher in patients with TIA accompanied by nonfocal symptoms (40.5 pmol/L, P=0.049) and with cardioembolic TIA (123.5 pmol/L; P=0.004) after adjustments for age, sex, atrial fibrillation, and a history of nonischemic heart disease. Patients with TNA also had higher mean NT-proBNP levels (20.8 pmol/L, P=0.38) than those with large-vessel TIA, but this difference was not statistically significant.
NT-proBNP levels are increased in patients with TIA accompanied by nonfocal symptoms.
短暂性非局灶性神经症状可能是心脏功能障碍的标志物。我们评估了血清N端前脑钠肽（NT-proBNP）水平（一种心脏病生物标志物）在伴有非局灶性症状的短暂性脑缺血发作（TIA）患者以及非局灶性症状发作（短暂性神经发作[TNA]）患者中是否升高。
我们纳入了15例TNA患者、69例伴有非局灶性症状的TIA患者、58例大血管性TIA患者、32例心源性栓塞性TIA患者以及46例年龄和性别匹配的健康对照者。在发作后1周内测定血清NT-proBNP水平。我们将心源性栓塞性TIA患者和混合性或非局灶性TNA患者的对数转换后的NT-proBNP水平与非心源性栓塞性TIA患者作为参照组进行比较。使用多元线性回归模型对年龄、性别、心房颤动和非缺血性心脏病病史进行了校正。在校正年龄、性别、心房颤动和非缺血性心脏病病史后，与大血管性TIA患者（平均14.2 pmol/L）相比，伴有非局灶性症状的TIA患者（40.5 pmol/L，P=0.049）和心源性栓塞性TIA患者（123.5 pmol/L；P=0.004）的平均NT-proBNP水平显著更高。TNA患者的平均NT-proBNP水平（20.8 pmol/L，P=0.38）也高于大血管性TIA患者，但这种差异无统计学意义。
伴有非局灶性症状的TIA患者的NT-proBNP水平升高。
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