Kirillova V V, Sokolova L A, Meshchaninov V N, Pershanova V I
Ural state medical University, Yekaterinburg, Russia.
Institute for medical cell technologies, Yekaterinburg, Russia.
Ter Arkh. 2018 Sep 20;90(9):68-72. doi: 10.26442/terarkh201890968-72.
The prevalence of chronic heart failure (CHF) remains high. Echocardiography is a reliable method of diagnosing heart failure. Determination of brain natriuretic peptide allows to identify patients with the most probable diagnosis of heart failure, which requires further instrumental examination of patients. To study the level of the brain natriuretic peptide in patients with diastolic chronic heart failure with preserved left ventricular ejection fraction.
The study included 96 outpatients with diastolic chronic heart failure I-III functional class with a preserved left ventricular ejection fraction at the age of 65.06 ± 1.15 years and 50 practically healthy people aged 39.90 ± 1.64 years as a control group who underwent a preventive examination. The level of the N-terminal fragment of the medullary natriuretic peptide (NT-proBNP) in serum was determined using a test system (Vector-Best, Russia).
The concentration of NT-proBNP in patients with diastolic heart failure with a preserved left ventricular ejection fraction was 108.18 ± 21.64 in the range from 0.0 to 1212.3 pg/ml compared to the control of 7.6 ± 1.38 pg/ml, p<0.05. A positive correlation was found between the concentration of NT-proBNP and the area of the left atrium (r=0.35), left ventricular E/e '(r=0.6), and left ventricular end-systolic volume (r=0.48). The level of NT-proBNP had no correlation with the functional class of CHF (r=0,23), as well as with the stage of CHF (r=0,23).
Thus, patients with diastolic CHF with a preserved ejection fraction in 67% of cases had a level of NT-proBNP in the blood less than the diagnostic threshold. The concentration of NT-proBNP in the serum positively correlates with increased pressure in the cavity of the left ventricle, the end-systolic volume in it and the area of the left atrium.
慢性心力衰竭(CHF)的患病率仍然很高。超声心动图是诊断心力衰竭的可靠方法。测定脑钠肽有助于识别最有可能诊断为心力衰竭的患者,这需要对患者进行进一步的器械检查。研究左心室射血分数保留的舒张性慢性心力衰竭患者的脑钠肽水平。
该研究纳入了96例年龄为65.06±1.15岁、左心室射血分数保留的I-III级舒张性慢性心力衰竭门诊患者,以及50例年龄为39.90±1.64岁的实际健康人作为对照组,他们接受了预防性检查。使用检测系统(俄罗斯Vector-Best公司)测定血清中髓质钠尿肽N端片段(NT-proBNP)的水平。
左心室射血分数保留的舒张性心力衰竭患者中,NT-proBNP浓度为108.18±21.64,范围为0.0至1212.3 pg/ml,而对照组为7.6±1.38 pg/ml,p<0.05。发现NT-proBNP浓度与左心房面积(r=0.35)、左心室E/e'(r=0.6)和左心室收缩末期容积(r=0.48)之间存在正相关。NT-proBNP水平与CHF的功能分级(r=0.23)以及CHF的阶段(r=0.23)均无相关性。
因此,67%的射血分数保留的舒张性CHF患者血液中NT-proBNP水平低于诊断阈值。血清中NT-proBNP浓度与左心室腔内压力升高、左心室收缩末期容积及左心房面积呈正相关。