Fukushima Keisuke, Ogawa Kazuo, Kawai Makoto, Yoshimura Michihiro
Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
Sci Rep. 2024 Dec 30;14(1):31711. doi: 10.1038/s41598-024-81922-w.
B-type natriuretic peptide (BNP) levels accurately reflect the degree of cardiac overload in heart failure. Considering cardiac morphology and intracardiac pressure, including the left ventricular end-systolic volume index (LVESVI) and left ventricular end-diastolic volume index (LVEDVI), is essential for cardiac overload assessment. These indexes influence plasma BNP levels, and high heart rate is likely associated with cardiac morphology. However, the direct relationship between high heart rate and plasma BNP levels remains unknown. In this study, we simultaneously measured various hemodynamic parameters and plasma BNP levels during cardiac catheterization in 5,429 inpatients with sinus rhythm at our hospital. Furthermore, we examined how heart rate is associated with cardiac morphology, intracardiac pressure, and plasma BNP levels via regression analysis and structure equation modeling (SEM). Univariate regression analysis revealed a significant positive correlation between heart rate and log BNP. The path model with SEM revealed significant positive relations of heart rate and LVESVI with left ventricular end-diastolic pressure, in addition to a significant negative relation of heart rate and LVEDVI with log BNP. Collectively, these findings suggest no positive relation (rather, a negative relation) between heart rate and log BNP and that high heart rate is indirectly associated with increased plasma BNP levels by altering cardiac morphology and intracardiac pressure.
B型利钠肽（BNP）水平准确反映心力衰竭时心脏负荷的程度。考虑心脏形态和心腔内压力，包括左心室收缩末期容积指数（LVESVI）和左心室舒张末期容积指数（LVEDVI），对于评估心脏负荷至关重要。这些指标影响血浆BNP水平，且高心率可能与心脏形态有关。然而，高心率与血浆BNP水平之间的直接关系仍不清楚。在本研究中，我们在我院对5429例窦性心律住院患者进行心导管检查时，同时测量了各种血流动力学参数和血浆BNP水平。此外，我们通过回归分析和结构方程模型（SEM）研究了心率与心脏形态、心腔内压力和血浆BNP水平之间的关联。单因素回归分析显示心率与log BNP之间存在显著正相关。SEM路径模型显示，心率和LVESVI与左心室舒张末期压力之间存在显著正相关，此外，心率和LVEDVI与log BNP之间存在显著负相关。总体而言，这些发现表明心率与log BNP之间不存在正相关（相反，存在负相关），且高心率通过改变心脏形态和心腔内压力与血浆BNP水平升高间接相关。
