Ziaie Naghmeh, Ezoji Khadijeh, Ziaei Seyedeh Golnaz, Chehrazi Mohammad, Maleh Parviz Amri, Pourkia Roghayeh, Seyfi Shahram
Babol, Iran Department of Cardiology, Babol University of Medical Sciences.
Babol, Iran Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences.
Int J Cardiovasc Imaging. 2022;38(6):1289-1296. doi: 10.1007/s10554-021-02513-8. Epub 2022 Mar 24.
Diastolic dysfunction has been reported in patients with COVID-19. Due to the role of N-terminal pro-brain natriuretic peptide (NT-proBNP) in the diagnosis of heart failure, this study investigated the relationship between serum NT-proBNP levels and diastolic heart failure in patients with COVID-19. This descriptive-analytical study was performed at Ayatollah Rouhani Hospital in Babol. Fifty-two patients with confirmed COVID-19 diagnosis, who were admitted to the ICU, were included in this study. The primary outcome was about the relationship and predictive role of NT-proBNP and diastolic heart failure in patients with severe SARS-CoV-2 infection. Patients with pro BNP > 125 pg/ml underwent echocardiography, and the relationship between echocardiographic indices and NT-proBNP was assessed as the secondary outcome. Our study showed that plasma NT-proBNP levels in patients with increased diastolic dysfunction were associated with disease severity. It was also found that the cut-off point of NT-proBNP = 799 pg/ml could be a predictor of diastolic dysfunction grades two and three. In this study, patients with a serum NT-proBNP level > 799 had 37 times higher chance of having diastolic dysfunction than those with a serum NT-proBNP < 799. Patients with NT-proBNP > 556 had RV_EA > 2 in echocardiography, indicating increased right-sided filling pressures. Despite the confounding factors in the interpretation of the NT-proBNP level in COVID-19, its level can be used to estimate the presence of high-grade diastolic heart failure on the left side and the right side of the heart and the presence of high filling pressures. Lower levels of NT-proBNP are associated with right-sided diastolic failure.
新冠病毒病（COVID-19）患者中已报告存在舒张功能障碍。由于N端脑钠肽前体（NT-proBNP）在心力衰竭诊断中的作用，本研究调查了COVID-19患者血清NT-proBNP水平与舒张性心力衰竭之间的关系。这项描述性分析研究在巴博勒的阿亚图拉·鲁哈尼医院进行。本研究纳入了52例确诊为COVID-19且入住重症监护病房的患者。主要结局是关于NT-proBNP与重症严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染患者舒张性心力衰竭的关系及预测作用。脑钠肽前体（pro BNP）>125 pg/ml的患者接受了超声心动图检查，超声心动图指标与NT-proBNP之间的关系作为次要结局进行评估。我们的研究表明，舒张功能障碍加重的患者血浆NT-proBNP水平与疾病严重程度相关。还发现NT-proBNP = 799 pg/ml的截断点可作为二级和三级舒张功能障碍的预测指标。在本研究中，血清NT-proBNP水平>799的患者发生舒张功能障碍的几率比血清NT-proBNP<799的患者高37倍。NT-proBNP>556的患者在超声心动图检查中右心室舒张早期与舒张晚期峰值流速比值（RV_EA）>2，表明右侧充盈压升高。尽管在解释COVID-19患者的NT-proBNP水平时存在混杂因素，但其水平可用于评估心脏左侧和右侧高级别舒张性心力衰竭的存在以及高充盈压的存在。较低的NT-proBNP水平与右侧舒张性心力衰竭相关。
