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2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT).2015年欧洲心脏病学会（ESC）/欧洲呼吸学会（ERS）肺动脉高压诊断和治疗指南：欧洲心脏病学会（ESC）和欧洲呼吸学会（ERS）肺动脉高压诊断和治疗联合工作组：得到以下组织认可：欧洲儿科和先天性心脏病协会（AEPC）、国际心肺移植学会（ISHLT）。
Eur Heart J. 2016 Jan 1;37(1):67-119. doi: 10.1093/eurheartj/ehv317. Epub 2015 Aug 29.
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Prognostic value of plasma B-type natriuretic peptide levels after exercise in patients with severe asymptomatic aortic stenosis.运动后血浆 B 型利钠肽水平对严重无症状主动脉瓣狭窄患者的预后价值。
Heart. 2014 Oct;100(20):1606-12. doi: 10.1136/heartjnl-2014-305729.
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Pulmonary vascular hemodynamic response to exercise in cardiopulmonary diseases.心肺疾病中运动对肺血管血液动力学的反应。
Circulation. 2013 Sep 24;128(13):1470-9. doi: 10.1161/CIRCULATIONAHA.112.000667.
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High-sensitive Troponin T increase after exercise in patients with pulmonary arterial hypertension.运动后肺动脉高压患者高敏肌钙蛋白 T 升高。
BMC Pulm Med. 2013 Apr 29;13:28. doi: 10.1186/1471-2466-13-28.
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Exercise dependence of N-terminal pro-brain natriuretic peptide in patients with precapillary pulmonary hypertension.运动依赖性 N 端脑利钠肽前体在肺毛细血管前性肺动脉高压患者中的作用。
Respiration. 2012;84(6):454-60. doi: 10.1159/000334950. Epub 2012 Feb 11.
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The prognostic impact of follow-up assessments in patients with idiopathic pulmonary arterial hypertension.特发性肺动脉高压患者随访评估的预后影响。
Eur Respir J. 2012 Mar;39(3):589-96. doi: 10.1183/09031936.00092311. Epub 2011 Sep 1.
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Determinants of absolute and relative exercise-induced changes in B-type natriuretic peptides.影响 B 型利钠肽在运动诱导下绝对和相对变化的因素。
Int J Cardiol. 2011 Mar 17;147(3):409-15. doi: 10.1016/j.ijcard.2009.09.546. Epub 2009 Nov 7.
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Assessment of functional capacity in clinical and research settings: a scientific statement from the American Heart Association Committee on Exercise, Rehabilitation, and Prevention of the Council on Clinical Cardiology and the Council on Cardiovascular Nursing.临床和研究环境中功能能力的评估：美国心脏协会临床心脏病学理事会运动、康复与预防委员会以及心血管护理理事会的科学声明
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NT-proBNP as a tool to stratify disease severity in pulmonary arterial hypertension.N末端B型利钠肽原作为肺动脉高压疾病严重程度分层的工具。
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Essential biochemistry and physiology of (NT-pro)BNP.（N-末端前体脑钠肽）的基础生物化学与生理学
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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.

DOI:10.1186/s12931-017-0712-9
PMID:29334941
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5769493/
Abstract

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.

摘要

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。