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心力衰竭患者中心肌肌钙蛋白 T 高敏与 B 型利钠肽及身体功能的关系。

Relationship between high-sensitivity cardiac troponin T, B-type natriuretic peptide, and physical function in patients with heart failure.

机构信息

Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan.

Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan.

出版信息

ESC Heart Fail. 2021 Dec;8(6):5092-5101. doi: 10.1002/ehf2.13577. Epub 2021 Sep 6.

Abstract

AIMS

High-sensitivity cardiac troponin T (hs-cTnT) and B-type natriuretic peptide (BNP) are associated with prognosis and severity in patients with heart failure (HF); however, their association with physical function is unclear. This study aimed to investigate whether hs-cTnT and BNP levels are associated with physical function in patients with HF.

METHODS AND RESULTS

Hs-cTnT, BNP, and physical function (maximal quadriceps isometric strength [QIS], usual gait speed, and 6-min walk distance [6MWD]) were evaluated in 363 consecutive patients with HF (median age, 70 [60-78] years). Patients were divided into four groups according to their median hs-cTnT and BNP levels. After adjusting for demographic characteristics, laboratory levels, and HF severity, higher hs-cTnT and BNP levels were significantly associated with lower physical function (log hs-cTnT, β = -0.162, P = 0.001, for maximal QIS; β = -0.175, P = 0.002, for usual gait speed, and β = -0.129, P = 0.004, for 6MWD; log BNP, β = -0.090, P = 0.092, for maximal QIS, β = 0.038, P = 0.516, for usual gait speed, and β = -0.108, P = 0.023, for 6MWD). In addition, the high hs-cTnT and high BNP group had significantly lower physical function (all P < 0.05) than the low hs-cTnT and low BNP group.

CONCLUSIONS

Higher hs-cTnT and BNP levels are both associated with lower physical function in patients with HF, but hs-cTnT levels showed a more consistent association. The combination of hs-cTnT and BNP may be effective for the stratification of physical function in patients with HF.

摘要

目的

高敏心肌肌钙蛋白 T(hs-cTnT)和 B 型利钠肽(BNP)与心力衰竭(HF)患者的预后和严重程度相关,但它们与身体功能的关系尚不清楚。本研究旨在探讨 hs-cTnT 和 BNP 水平与 HF 患者身体功能的关系。

方法和结果

连续评估了 363 例 HF 患者(中位年龄 70[60-78]岁)的 hs-cTnT、BNP 和身体功能(最大股四头肌等长强度[QIS]、常规步行速度和 6 分钟步行距离[6MWD])。根据 hs-cTnT 和 BNP 的中位数将患者分为四组。调整人口统计学特征、实验室水平和 HF 严重程度后,较高的 hs-cTnT 和 BNP 水平与较低的身体功能显著相关(log hs-cTnT,β=-0.162,P=0.001,用于最大 QIS;β=-0.175,P=0.002,用于常规步行速度,β=-0.129,P=0.004,用于 6MWD;log BNP,β=-0.090,P=0.092,用于最大 QIS,β=0.038,P=0.516,用于常规步行速度,β=-0.108,P=0.023,用于 6MWD)。此外,高 hs-cTnT 和高 BNP 组的身体功能明显低于低 hs-cTnT 和低 BNP 组(均 P<0.05)。

结论

较高的 hs-cTnT 和 BNP 水平均与 HF 患者的身体功能降低相关,但 hs-cTnT 水平的相关性更为一致。hs-cTnT 和 BNP 的联合检测可能有助于对 HF 患者身体功能进行分层。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a55/8712903/15c82b39446a/EHF2-8-5092-g001.jpg

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