The association between NT-proBNP levels, functional capacity and stage in patients with heart failure
The association between NT-proBNP levels, functional capacity and stage in patients with heart failure
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DOI：
10.2143/ac.60.6.2004936
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发表时间：
2005-12-01
影响因子：
1.6
通讯作者：
Toprak, N
中科院分区：
文献类型：
--
作者：
Karabulut, A;Kaplan, A;Toprak, N
目的-氨基末端前脑利钠肽(NT-proBNP)是BNP的生物活性衍生物，具有半衰期长、血药浓度高、个体间变异小、体外稳定性高等优点，具有较高的临床应用价值。在这一点上，NT-proBNP可能是反映心功能不全严重程度的更好指标。本研究探讨了慢性心力衰竭患者血浆NT-ProBNP水平与心功能及心力衰竭分期的关系，并重点探讨了慢性心力衰竭A期患者中神经激素激活的存在及其意义。方法与结果：心力衰竭患者(男31例，女33例；平均年龄58.26±10.59岁)和健康对照组36例(男24例，女12例；平均年龄57.47±10.83岁)。心功能分级采用纽约心脏协会(NYHA)分级系统(I、II、III、IV)，心力衰竭分级依据ACC/AHA指南(A、B、C、D)。与男性参与者相比，健康女性参与者的NT-ProBNP水平更高(p<；0.001)。左心室射血分数(LVEF)与功能容量和疾病分期无明显相关性。与对照组相比，充血性心力衰竭患者的NT-ProBNP水平升高(p<；0.001)。NT-proBNP与患者的功能能力呈正相关，且随疾病分级的增加而显著升高。同样，心力衰竭分期与NT-proBNP水平呈正相关，随着疾病分期的增加而显著增加。NYHA I期和A期患者的NT-proBNP水平明显高于对照组(p=0.04)。结论：通过测定循环中的NT-proBNP水平可以客观地评价CHF的严重程度。即使在NYHA I期和A期疾病中，NT-proBNP水平也高于对照组(p=0.04)。NT-proBNP可提供有关疾病严重程度的客观信息，也有助于CHF患者的治疗决定。
Objective - Amino-terminal probrain natriuretic peptide (NT-proBNP), a biologically inactive derivative of BNP, is clinically more useful owing to its longer half-life, higher plasma concentrations, lesser variation among individuals, and higher in vitro stability. In this regard, NT-proBNP may be a better indicator of the severity of ventricular dysfunction. In this study, the association of NT-proBNP levels with functional capacity and stage of heart failure was explored in patients with CHF Also, we particularly focused on the presence and significance of neurohormonal activation in the group of patients classified as stage-A according to ACC/AHA guidelines.Methods and results - 64 patients with CHF (31 men, 33 women; mean age 58.26 +/- 10.59 y) and 36 healthy controls (24 men, 12 women; mean age 57.47 +/- 10.83) were included in this study. The New York Heart Association (NYHA) classification system (I, II, III, IV) was used to define the functional capacity; and the stage of the heart failure was based on the ACC/AHA guidelines (A, B, C, D). Healthy female participants had higher NT-proBNP levels compared to their male counterparts (p < 0.001). Left ventricular ejection fraction (LVEF) did not correlate significantly with functional capacity and stage of the disease. CHF patients had higher NT-proBNP compared to controls (p < 0.001). There was a positive correlation between NT-proBNP and functional capacity in patients, and NT-proBNP increased significantly with each increasing class of the disease. Similarly, a positive correlation existed between the stage of heart failure and NT-proBNP levels, which increased significantly with increasing stages of the disease. Patients with NYHA I and stage A disease had higher NT-proBNP levels compared to controls (p = 0.04).Conclusions - The severity of CHF can be objectively assessed by measuring the circulating levels of NT-proBNP. Even in NYHA I and stage A disease, NT-proBNP levels are higher compared to controls (p = 0.04). NT-proBNP can provide objective information regarding the severity of the disease and also aid in treatment decisions in patients with CHF.