Dahle M G, Simonsen S, Hall C, Kjekshus J K
Department of Medicine B, Rikshospitalet, University Hospital, Oslo, Norway.
Scand J Clin Lab Invest. 1998 Aug;58(5):395-403. doi: 10.1080/00365519850186373.
The aim was to examine the usefulness of plasma N-terminal proatrial natriuretic factor (N-terminal proANP) as a non-invasive marker of cardiac pressure in patients with normal to mildly elevated serum creatinine.
Blood samples were drawn at rest from 100 patients with cardiac disease undergoing diagnostic cardiac catheterization.
Using multivariate analysis, N-terminal proANP was independently related to mean pulmonary capillary wedge pressure (PCWP), mean right atrial pressure, serum creatinine (s-creatinine) and cardiac index. These indices accounted for about 50% of the variation in N-terminal proANP. All patients with N-terminal proANP < 1000 pmol/l had normal PCWP (< 13 mmHg). Areas under the receiver-operating characteristic (ROC) curves for N-terminal proANP for the detection of PCWP > or = 13, > or = 18 and > or = 24 mmHg were 0.903, 0.870 and 0.876, respectively.
These results suggest that analysis of plasma N-terminal proANP is a simple and powerful method for assessing cardiac pressure in patients with heart disease and normal and mildly elevated s-creatinine (< 165 micromol/l). The value of N-terminal proANP cannot, however, indiscriminately be used to assess cardiac haemodynamics. N-terminal proANP measurement is a useful screening parameter for identifying patients with normal cardiac pressures.
旨在研究血浆N末端前心钠素（N-terminal proANP）作为血清肌酐正常至轻度升高患者心脏压力无创标志物的实用性。
对100例接受诊断性心导管检查的心脏病患者在静息状态下采集血样。
通过多变量分析，N末端前心钠素与平均肺毛细血管楔压（PCWP）、平均右心房压力、血清肌酐（s-creatinine）和心脏指数独立相关。这些指标约占N末端前心钠素变化的50%。所有N末端前心钠素<1000 pmol/l的患者PCWP均正常（<13 mmHg）。N末端前心钠素检测PCWP≥13、≥18和≥24 mmHg时的受试者操作特征（ROC）曲线下面积分别为0.903、0.870和0.876。
这些结果表明，分析血浆N末端前心钠素是评估心脏病患者以及血清肌酐正常和轻度升高（<165 μmol/l）患者心脏压力的一种简单而有效的方法。然而，N末端前心钠素的值不能不加区分地用于评估心脏血流动力学。N末端前心钠素测量是识别心脏压力正常患者的有用筛查参数。
