Prognostic Significance of B-Type Natriuretic Peptide in Patients With Left Ventricular Thrombus.
Prognostic Significance of B-Type Natriuretic Peptide in Patients With Left Ventricular Thrombus.
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B型利钠肽对左心室血栓患者的预后意义
DOI：
10.3389/fcvm.2021.667908
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发表时间：
2021
影响因子：
3.6
通讯作者：
Qin Z
中科院分区：
文献类型：
--
作者：
An Z;Gao Z;Wang L;Hou C;Zhang L;Gong S;Rao R;Li C;Qin Z
背景和目标：关于B型利钠肽（BNP）对左心室血栓（LVT）患者预后价值的信息很少。方法：纳入2009年11月至2020年7月在我院经胸超声心动图诊断为LVT的患者。终点为全因死亡率和全身性栓塞。结果：92例受试者最终纳入研究。队列的平均年龄为56.73 ± 14.12岁，80.4%的患者为男性。中位BNP（第一四分位数−第三四分位数）为437.5（112.74-1317.5）。全因死亡率为30.44%（28/92），1年、2年和3年累积生存率分别为85.4%、75.5%和66.5%。在10例受试者中发现了全身栓塞。考克斯多变量分析显示Log BNP（HR，4.16; 95%CI，1.81-9.56; P = 0.001）和BMI（HR，0.86; 95%CI，0.73-0.99; P = 0.048）与全因死亡率显著相关。此外，BNP水平处于中位数上限（≥ 437.5 pg/ml）的患者的全因死亡率显著高于BNP水平中位数较低的患者（<437.5 pg/ml; P = 0.004）。BNP和全因死亡率的受试者工作特征曲线下面积为0.71。在线性趋势检验中，BNP四分位数与所有模型中的全因死亡率显著相关，模型1、2和3中趋势的P值分别为0.005、0.006和0.048。结论：BNP水平是预测LVT患者全因死亡率的一个重要因素，BNP水平升高提示LVT风险增高。
Background and Aims: There is sparse information on the prognostic value of B-type natriuretic peptide (BNP) for the outcomes in patients with left ventricular thrombus (LVT). Methods: Patients diagnosed with LVT by transthoracic echocardiography between November 2009 to July 2020 at our institution were included. The endpoints were all-cause mortality and systemic embolism. Results: Ninety-two subjects were finally included in the study. The mean age of the cohort was 56.73 ± 14.12, and 80.4% of the patients were male. The median BNP (1st quartile−3rd quartile) was 437.5 (112.74–1317.5). The total all-cause mortality rate was 30.44% (28/92), and the 1-year, 2-year, and 3-year cumulative survival rates were 85.4, 75.5, and 66.5%, respectively. Systemic embolism was identified in 10 subjects. COX multivariate analysis showed that Log BNP (HR, 4.16; 95%CI, 1.81–9.56; P = 0.001) and BMI (HR, 0.86; 95%CI, 0.73–0.99; P = 0.048) were significantly associated with all-cause mortality. In addition, patients with BNP levels in the upper median (≥ 437.5 pg/ml) had significantly higher all-cause mortality rate compared to those with lower median BNP (<437.5 pg/ml; P = 0.004). The area under the receiver operating characteristic curve for BNP and all-cause mortality was 0.71. In the linear trend test, BNP quartiles were significantly related to all-cause mortality in all models, and the P-values for trend in models 1, 2, and 3 were 0.005, 0.006, and 0.048, respectively. Conclusion: BNP level is a prognostic factor for all-cause mortality in LVT patients, and elevated BNP is indicative of a higher risk of LVT.
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