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不稳定型心绞痛合并糖尿病且左心室射血分数正常患者的 NT-proBNP 水平与左心室射血分数的关系。

Relationship Between NT-proBNP Levels and Left Ventricular Ejection Fraction in Patients with Unstable Angina and Diabetes Mellitus and Preserved LVEF.

机构信息

Department of Cardiology, Beijing Friendship Hospital, Capital Medical University.

Department of Comprehensive Medicine, Beijing Friendship Hospital, Capital Medical University.

出版信息

Int Heart J. 2022;63(5):821-827. doi: 10.1536/ihj.22-160.

Abstract

N-terminal pro-B-type natriuretic peptide (NT-proBNP) is suggested to be altered in patients with systolic heart failure or acute coronary syndrome. We explored the relationship between left ventricular ejection fraction (LVEF) and levels of NT-proBNP in patients with unstable angina and type 2 diabetes mellitus and preserved LVEF.Patients with unstable angina were divided into normal glucose tolerance (controls) and type 2 diabetes mellitus groups. The plasma NT-proBNP concentration was measured in these patients within 30 minute of admission for a comparative study. The severity of coronary arterial lesions was evaluated using Syntax scores. Results: NT-proBNP levels were not significantly different in patients with unstable angina and type 2 diabetes mellitus (median [quartiles]: 167.0 [66.1, 623.3] pg/mL) from those of controls (116.0 [69.8, 233.0], P = 0.278). Subsequent analyses indicated that ln (NT-proBNP) was positively associated with the following parameters: left ventricular end-diastolic diameter (r = 0.495, P = 0.019), left ventricular end-systolic diameter (r = 0.648, P = 0.001), and Syntax score (r = 0.567, P = 0.006); ln (NT-proBNP) was negatively associated with LVEF (r = -0.652, P = 0.001) in patients with unstable angina and type 2 diabetes mellitus. In multiple linear regression analysis, ln (NT-proBNP) levels were significantly independently correlated with the LVEF and Syntax score. However, no correlation was observed between ln (NT-proBNP) and each parameter in patients with unstable angina and normal glucose tolerance (controls).The NT-proBNP level is independently correlated with the LVEF in patients with unstable angina and type 2 diabetes mellitus and preserved LVEF.

摘要

N-末端脑利钠肽前体(NT-proBNP)被认为在收缩性心力衰竭或急性冠状动脉综合征患者中发生改变。我们探讨了左心室射血分数(LVEF)与不稳定型心绞痛和 2 型糖尿病伴保留 LVEF 患者的 NT-proBNP 水平之间的关系。将不稳定型心绞痛患者分为正常糖耐量(对照组)和 2 型糖尿病组。在这些患者入院 30 分钟内测量其血浆 NT-proBNP 浓度,进行对比研究。采用 Syntax 评分评估冠状动脉病变严重程度。结果:与对照组(116.0 [69.8, 233.0] pg/mL)相比,不稳定型心绞痛合并 2 型糖尿病患者的 NT-proBNP 水平无显著差异(中位数 [四分位数]:167.0 [66.1, 623.3] pg/mL,P = 0.278)。进一步分析表明,ln(NT-proBNP)与以下参数呈正相关:左心室舒张末期直径(r = 0.495,P = 0.019)、左心室收缩末期直径(r = 0.648,P = 0.001)和 Syntax 评分(r = 0.567,P = 0.006);ln(NT-proBNP)与不稳定型心绞痛合并 2 型糖尿病患者的 LVEF 呈负相关(r = -0.652,P = 0.001)。在多元线性回归分析中,ln(NT-proBNP)水平与 LVEF 和 Syntax 评分显著独立相关。然而,在不稳定型心绞痛伴正常糖耐量(对照组)患者中,ln(NT-proBNP)与各参数之间均无相关性。在不稳定型心绞痛合并保留 LVEF 的 2 型糖尿病患者中,NT-proBNP 水平与 LVEF 独立相关。

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