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肥厚型心肌病：高敏肌钙蛋白 I 和 NT-proBNP 评估的缺血与左心室功能障碍的时间同步关系。

Hypertrophic Cardiomyopathy: The Time-Synchronized Relationship between Ischemia and Left Ventricular Dysfunction Assessed by Highly Sensitive Troponin I and NT-proBNP.

机构信息

Second Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland.

Second Department of Cardiology, Jagiellonian University Collegium Medicum, Krakow, Poland.

出版信息

Dis Markers. 2019 Jun 20;2019:6487152. doi: 10.1155/2019/6487152. eCollection 2019.

DOI:10.1155/2019/6487152
PMID:31320942
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6610740/
Abstract

The aim of this study was to compare NT-proBNP using the absolute values and NT-proBNP/ULN values that were standardized by age and gender between three subgroups: those without ischemia (negative hs-troponin I and no anginal pain (hsTnI-/AP-)), those with painless ischemia (hsTnI+/AP-), and those with painful ischemia (hsTnI+/AP+). Additionally, echocardiographic parameters were compared in these three subgroups. The absolute value of NT-proBNP was significantly higher in the painful ischemia subgroup (hsTnI-/AP- vs. hsTnI+/AP- vs. hsTnI+/AP+: 502 (174-833) vs. 969 (363-1346) vs. 2053 (323-3283) pg/ml; = 0.018 for the whole-model analysis). The standardized value of NT-proBNP/ULN was gradually increased (hsTnI-/AP- vs. hsTnI+/AP- vs. hsTnI+/AP+: 3.61 + 0.63 vs. 6.90 + 1.31 vs. 9.35 + 1.87; = 0.001 for the whole-model analysis). In the comparison between subgroups (hsTnI-/AP- vs. hsTnI+/AP- vs. hsTnI+/AP+), two echocardiographic parameters increased significantly. The left ventricular maximum wall thickness (LVMWT) at diastole was 1.99 ± 0.08 cm vs. 2.28 ± 0.13 cm vs. 2.49 ± 0.15 cm ( = 0.004 for the whole-model analysis). The maximal gradient of the provoked left ventricular outflow tract (LVOT) gradient increased significantly in only the painful-ischemia subgroup (11 (7-30) mmHg vs. 12 (9.35-31.5) mmHg vs. 100 (43-120) mmHg). In conclusion, both painless ischemia and painful ischemia are associated with a gradual, significant increase in NT-proBNP/ULN in comparison to the double-negative hsTnI/AP subgroup. In contrast, NT-proBNP is significantly higher in only the subgroup with painful ischemia.

摘要

本研究旨在比较三组亚组（无缺血（阴性 hs-肌钙蛋白 I 和无胸痛（hsTnI-/AP-））、无痛性缺血（hsTnI+/AP-）和有痛性缺血（hsTnI+/AP+））之间 NT-proBNP 的绝对值和按年龄和性别标准化的 NT-proBNP/ULN 值。此外，还比较了这三组亚组的超声心动图参数。有痛性缺血亚组的 NT-proBNP 绝对值显著升高（hsTnI-/AP-比 hsTnI+/AP-比 hsTnI+/AP+：502（174-833）比 969（363-1346）比 2053（323-3283）pg/ml；整体模型分析的 = 0.018）。NT-proBNP/ULN 的标准化值逐渐增加（hsTnI-/AP-比 hsTnI+/AP-比 hsTnI+/AP+：3.61+0.63 比 6.90+1.31 比 9.35+1.87；整体模型分析的 = 0.001）。在亚组之间的比较中（hsTnI-/AP-比 hsTnI+/AP-比 hsTnI+/AP+），有两个超声心动图参数显著增加。舒张末期左心室最大壁厚度（LVMWT）为 1.99±0.08cm 比 2.28±0.13cm 比 2.49±0.15cm（整体模型分析的 = 0.004）。仅在有痛性缺血亚组中，诱发左心室流出道（LVOT）梯度的最大梯度显著增加（11（7-30）mmHg 比 12（9.35-31.5）mmHg 比 100（43-120）mmHg）。总之，与双阴性 hsTnI/AP 亚组相比，无痛性缺血和有痛性缺血均与 NT-proBNP/ULN 的逐渐显著增加相关。相反，只有有痛性缺血亚组的 NT-proBNP 显著升高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdbf/6610740/521abc3fecfa/DM2019-6487152.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdbf/6610740/d66c4501e36e/DM2019-6487152.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdbf/6610740/6844c119a718/DM2019-6487152.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdbf/6610740/7c257cf1022a/DM2019-6487152.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdbf/6610740/73644628b248/DM2019-6487152.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdbf/6610740/521abc3fecfa/DM2019-6487152.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdbf/6610740/d66c4501e36e/DM2019-6487152.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdbf/6610740/6844c119a718/DM2019-6487152.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdbf/6610740/7c257cf1022a/DM2019-6487152.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdbf/6610740/73644628b248/DM2019-6487152.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdbf/6610740/521abc3fecfa/DM2019-6487152.005.jpg

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