Chaminda Rathnayake B M, Illeperuma Rasika Pawiththra, Jayasinghe Sakunthala, Fawcett Tonks N, Maduwage Kalana, Thilak Jayalath W A, Ralapanawa Udaya
Department of Nursing, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka,
Center for Research in Oral Cancer, Faculty of Dental Science, University of Peradeniya, Peradeniya, Sri Lanka,
EJIFCC. 2023 Dec 21;34(4):287-296. eCollection 2023 Dec.
BACKGROUND/AIMS: Only a few studies have addressed the role of NT-proBNP in identifying Left Ventricular Systolic Dysfunction (LVSD) in South Asian populations. Therefore, the current study was aimed at assessing the use of serum NT-proBNP in predicting LVSD in a hospitalized population in Sri Lanka.
A random sample of 278 individuals referred for echocardiography at a major Teaching Hospital consented for venous blood samples to be collected for serum NT-proBNP assay by sandwich ELISA. Based on the ejection fraction (LVEF) and fractional shortening (FS), participants were differentiated as LVSD (LVEF<50%, FS≤ 29%) and non-LVSD individuals (LVEF>60%). According to inclusion/exclusion criteria, the final study sample consisted of 100 LVSD patients and 41 non-LVSD individuals.
The mean ages of the LVSD and non-LVSD groups were 69.1 (±6.2 years) and 71.4 (±2.4 years) (p=0.066) respectively. The median NT-proBNP value (with IQR) among LVSD patients (528.2 pg/mL,355.2-924.2) was comparatively higher than that of non-LVSD individuals (207.3 pg/mL,177.5-343.0). Strong correlations of NT-proBNP level with LVEF (Spearman -0.84, p<0.001) and FS ( -0.81, <0.001) suggested that serum NT-proBNP concentration increases in parallel to deteriorating left ventricular functions. The AUROC of serum NT-proBNP for differentiating LVSD was 0.859 (95% CI:0.79 - 0.92) and the optimal cut-off level for predicting LVSD was 265pg/mL, with 90% sensitivity and 70% specificity.
Current Sri Lankan study revealed a considerable correlation of serum NT-proBNP level with LVSD and utilizing such an assay for screening will facilitate adequate evidence to rule-out LVSD among high-risk residents.
背景/目的：仅有少数研究探讨了N末端B型利钠肽原（NT-proBNP）在南亚人群左心室收缩功能障碍（LVSD）识别中的作用。因此，本研究旨在评估血清NT-proBNP在预测斯里兰卡住院人群LVSD中的应用。
在一家大型教学医院，随机抽取278名接受超声心动图检查的个体，同意采集静脉血样本，通过夹心酶联免疫吸附测定法（ELISA）检测血清NT-proBNP。根据射血分数（LVEF）和缩短分数（FS），将参与者分为LVSD组（LVEF<50%，FS≤29%）和非LVSD组（LVEF>60%）。根据纳入/排除标准，最终研究样本包括100例LVSD患者和41例非LVSD个体。
LVSD组和非LVSD组的平均年龄分别为69.1（±6.2岁）和71.4（±2.4岁）（p=0.066）。LVSD患者的NT-proBNP中位数（四分位间距）值（528.2 pg/mL，355.2 - 924.2）高于非LVSD个体（207.3 pg/mL，177.5 - 343.0）。NT-proBNP水平与LVEF（Spearman相关性 -0.84，p<0.001）和FS（ -0.81，p<0.001）的强相关性表明，血清NT-proBNP浓度随左心室功能恶化而平行升高。血清NT-proBNP区分LVSD的受试者工作特征曲线下面积（AUROC）为0.859（95%CI：0.79 - 0.92），预测LVSD的最佳截断水平为265 pg/mL，敏感性为90%，特异性为70%。
当前斯里兰卡的研究表明血清NT-proBNP水平与LVSD存在显著相关性，利用该检测方法进行筛查将有助于获得充分证据以排除高危人群中的LVSD。
