Gong Hui, Wang Xin, Shi Yi-Jun, Shang Wen-Jing, Ling Y I, Pan Li-Jian, Shi Hai-Ming
Department of Internal Medicine, Division of Cardiology, Huashan Hospital of Fudan University, Shanghai 200040, P.R. China.
Department of Medicine and Therapeutics, Division of Cardiology, Jinshan Hospital of Fudan University, Shanghai 200540, P.R. China.
Exp Ther Med. 2016 Jun;11(6):2583-2589. doi: 10.3892/etm.2016.3203. Epub 2016 Mar 30.
The present study aimed to investigate the association between brain natriuretic peptide (BNP) levels and the prognosis of patients with left ventricular (LV) diastolic dysfunction. A total of 708 inpatients with cardiovascular disease (mean age, 66 years; 395 males and 313 females) were grouped according to initial BNP and were followed-up for 20-51 months (average, 30.86 months) until endpoint events occurred. Endpoints were defined as mortality or readmission due to cardiovascular disease, or mortality due to any other reason. A total of 67 and 77 events were reported in the BNP ≤80 pg/ml and BNP >80 pg/ml groups, respectively. The occurrence rate of the endpoint was significantly higher in the BNP >80 pg/ml group, as compared with the BNP ≤80 pg/ml group (26.28 vs. 16.14%; relative risk=1.63). Furthermore, the durations of patient survival were significantly shorter in the BNP >80 pg/ml group, as compared with the BNP ≤80 pg/ml group (P=0.0006), and patient survival decreased as BNP levels rose (P=0.0074). Among the 708 patients, 677 underwent echocardiographic detection at the same time. No significant correlation was detected between BNP levels and survival time in 178 patients with normal LV diastolic function [mitral Doppler flow, early diastolic (E)/late diastolic (A)>1] (P=0.2165); whereas a negative correlation was determined in 499 patients with LVD dysfunction (E/A≤1) (Spearman's rho=-0.0899; P=0.0447). The prognoses of patients with elevated BNP levels were correspondingly worse in the present study and these correlations were demonstrated to be significant in patients with LV diastolic dysfunction. Therefore, BNP levels may be used to predict the prognosis of patients with cardiovascular disease.
本研究旨在探讨脑钠肽（BNP）水平与左心室（LV）舒张功能障碍患者预后之间的关联。共有708例心血管疾病住院患者（平均年龄66岁；男性395例，女性313例）根据初始BNP水平进行分组，并随访20 - 51个月（平均30.86个月），直至发生终点事件。终点事件定义为因心血管疾病导致的死亡或再次入院，或因任何其他原因导致的死亡。BNP≤80 pg/ml组和BNP>80 pg/ml组分别报告了67例和77例事件。与BNP≤80 pg/ml组相比，BNP>80 pg/ml组的终点事件发生率显著更高（26.28%对16.14%；相对风险 = 1.63）。此外，与BNP≤80 pg/ml组相比，BNP>80 pg/ml组患者的生存时间显著缩短（P = 0.0006），且随着BNP水平升高，患者生存率下降（P = 0.0074）。在这708例患者中，677例同时接受了超声心动图检测。在178例左心室舒张功能正常[二尖瓣多普勒血流，舒张早期（E）/舒张晚期（A）>1]的患者中，未检测到BNP水平与生存时间之间存在显著相关性（P = 0.2165）；而在499例左心室舒张功能障碍（E/A≤1）的患者中，确定存在负相关性（Spearman秩相关系数=-0.0899；P = 0.0447）。在本研究中，BNP水平升高的患者预后相应较差，并且这些相关性在左心室舒张功能障碍患者中被证明具有显著性。因此，BNP水平可用于预测心血管疾病患者的预后。
