运动诱导的氨基末端脑利钠肽前体反应与未经治疗的肺动脉高压患者疾病严重程度的相关性：一项队列研究。
The association of the N-terminal pro-brain-type natriuretic peptide response to exercise with disease severity in therapy-naive pulmonary arterial hypertension: a cohort study.
机构信息
Department of Cardiology, Respiratory Medicine and Intensive Care, Klinikum Augsburg, Ludwig-Maximilians-University Munich, Stenglinstrasse 2, 86156, Augsburg, Germany.
出版信息
Respir Res. 2018 Jan 15;19(1):8. doi: 10.1186/s12931-017-0712-9.
BACKGROUND
While the N-terminal pro-brain-type natriuretic peptide (NT-proBNP) at rest is known to be associated with prognosis in pulmonary arterial hypertension (PAH), it is unclear if the NT-proBNP response to exercise (ΔNT-proBNP) can contribute to a better assessment of disease severity.
METHODS
We investigated the association of NT-proBNP values at rest and during peak exercise with hemodynamics and cardiopulmonary exercise testing parameters in 63 therapy-naive PAH patients.
RESULTS
The median NT-proBNP increases from 1414 at rest to 1500 pg/ml at peak exercise. The ΔNT-proBNP is baseline-dependent in PAH. Both, NT-proBNP at rest and NT-proBNP at peak exercise, are significantly correlated with hemodynamics and functional capacity. However, neither NT-proBNP at peak exercise nor ΔNT-proBNP correlated better with surrogate markers of disease severity than NT-proBNP at rest.
CONCLUSION
The ΔNT-proBNP does not contribute to a better assessment of disease severity in PAH.
背景
虽然静息状态下的 N 末端脑利钠肽前体（NT-proBNP）与肺动脉高压（PAH）的预后相关，但目前尚不清楚运动时的 NT-proBNP 反应（ΔNT-proBNP）是否可以更好地评估疾病严重程度。
方法
我们研究了 63 例未经治疗的 PAH 患者的静息和峰值运动时的 NT-proBNP 值与血流动力学和心肺运动测试参数之间的关系。
结果
NT-proBNP 中位数从静息时的 1414pg/ml 增加到峰值运动时的 1500pg/ml。PAH 患者的 ΔNT-proBNP 与基线相关。静息时和峰值运动时的 NT-proBNP 均与血流动力学和功能能力显著相关。然而，无论是峰值运动时的 NT-proBNP 还是 ΔNT-proBNP，都与疾病严重程度的替代标志物的相关性均不如静息时的 NT-proBNP。
结论
ΔNT-proBNP 不能更好地评估 PAH 的疾病严重程度。
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