Department of Cardiology, Beijing Friendship Hospital, Capital Medical University.
Department of Comprehensive Medicine, Beijing Friendship Hospital, Capital Medical University.
Int Heart J. 2022;63(5):821-827. doi: 10.1536/ihj.22-160.
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.
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。