Quantifying Cardiac Hemodynamic Stress and Cardiomyocyte Damage in Ischemic and Nonischemic Acute Heart Failure
Quantifying Cardiac Hemodynamic Stress and Cardiomyocyte Damage in Ischemic and Nonischemic Acute Heart Failure
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DOI：
10.1161/circheartfailure.111.961243
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发表时间：
2012-01-01
影响因子：
9.7
通讯作者：
Mueller, Christian
中科院分区：
文献类型：
--
作者：
Drexler, Beatrice;Heinisch, Corinna;Mueller, Christian
背景 - 急诊科 (ED) 中缺血性和非缺血性急性心力衰竭 (AHF) 的早期和非侵入性鉴别是一个未满足的临床需求。方法和结果 - 我们使用 B 型钠尿肽 (BNP) 量化心脏血流动力学应激，并使用 2 种不同的心肌肌钙蛋白测定对 718 名连续出现 AHF 的 ED 患者（衍生队列）量化心肌细胞损伤。缺血性 AHF 的诊断是根据包括冠状动脉造影在内的所有信息来判定的。研究结果在第二个独立多中心队列（326 名 AHF 患者）中得到验证。在 718 名患者中，400 名（56%）被判定患有缺血性 AHF。与非缺血性 AHF 相比，缺血性 AHF 中的 BNP 水平显着较高（1097 [604-1525] pg/mL 对比 800 [427-1317] pg/mL；P
Background-The early and noninvasive differentiation of ischemic and nonischemic acute heart failure (AHF) in the emergency department (ED) is an unmet clinical need.Methods and Results-We quantified cardiac hemodynamic stress using B-type natriuretic peptide (BNP) and cardiomyocyte damage using 2 different cardiac troponin assays in 718 consecutive patients presenting to the ED with AHF (derivation cohort). The diagnosis of ischemic AHF was adjudicated using all information, including coronary angiography. Findings were validated in a second independent multicenter cohort (326 AHF patients). Among the 718 patients, 400 (56%) were adjudicated to have ischemic AHF. BNP levels were significantly higher in ischemic compared with nonischemic AHF (1097 [604-1525] pg/mL versus 800 [427-1317] pg/mL; P