Relationship of resting B-type natriuretic peptide level to cardiac work and total physical work capacity in heart failure patients.
Relationship of resting B-type natriuretic peptide level to cardiac work and total physical work capacity in heart failure patients.
复制标题
心力衰竭患者静息 B 型利钠肽水平与心脏做功和总体力做功的关系。
DOI：
10.1097/hcr.0b013e3181ac7bcb
复制
发表时间：
2009
影响因子：
3.8
通讯作者：
Krueger,StevenK
中科院分区：
文献类型：
--
作者：
Norman,JosephF;Pozehl,BunnyJ;Duncan,KathleenA;Hertzog,MelodyA;Elokda,AhmedS;Krueger,StevenK
静息状态下血浆B型利钠肽（BNP）水平与总体功能容量指标峰值摄氧量（V ~ O2 peak）和每分钟通气量/二氧化碳（VE/V ~ CO2）斜率相关。本研究的目的是评估血浆BNP水平与心率-血压乘积（RPP）的关系，将其作为中枢或心脏作功能力的指标。方法：招募了22例（12例男性），平均年龄57±12岁，诊断为心力衰竭（8例缺血性/14例非缺血性）。所有受试者在接受最佳药物治疗至少1个月后病情稳定。在休息时采集用于BNP水平分析的血液样本。受试者进行了限制性活动平板运动试验，采用斜升方案，同时监测V ~ 2 O2、心率（HR）和血压（BP）。BNP水平与RPP水平、VTO 2峰值、VE/VTOCO 2斜率、潮气末CO2压（PETCO 2）、左室射血分数（LVEF）之间的相关性分析表明，静息BNP水平与RPP水平呈显著正相关（r=-0.69）。BNP水平和RPP水平与VTO 2峰值（r=-0.63和r= 0.66）和VE/VTOCO 2斜率（r= 0.53和r=-0.54）相关。RPP水平与PETCO 2呈正相关（r= 0.57），BNP水平与PETCO 2无相关性。BNP和RPP水平与LVEF均无明显相关性（r=-0.26和r= 0.14）。结论：本研究结果提示，静息血浆BNP水平可能是评价心力衰竭患者整体功能和心肌特异性作功能力的一个有用的临床指标。
PURPOSEPlasma B-type natriuretic peptide (BNP) levels obtained at rest have been previously shown to be correlated with the global functional capacity measures of peak oxygen uptake (V̇O 2peak) and the minute ventilation/carbon dioxide (VE/V̇CO 2) slope. The purpose of this study was to assess the relationship of the plasma BNP level to the rate-pressure product (RPP) as an indicator of central or cardiac work capacity.METHODSTwenty-two subjects (12 men), mean age 57±12 years, diagnosed with heart failure (8 ischemic/14 nonischemic) were recruited. All subjects were stable on optimal medical therapy for at least 1 month. Blood samples for BNP level analysis were obtained at rest. Subjects underwent a symptom-limited treadmill exercise test using a ramping protocol while V̇O 2, heart rate (HR), and blood pressure (BP) were monitored. Correlation analyses were conducted to assess the relationship of BNP level to RPP level, V̇O 2peak, VE/V̇CO 2 slope, end-tidal CO 2 pressure (P ET CO 2), and left ventricular ejection fraction (LVEF).RESULTSResting BNP levels were significantly correlated with RPP levels (r=− 0.69). The BNP level and the RPP level were correlated with V̇O 2peak (r=− 0.63 and r= 0.66, respectively) and VE/V̇CO 2 slope (r= 0.53 and r=− 0.54, respectively). The RPP level but not the BNP level was correlated with P ET CO 2 (r= 0.57). Neither BNP nor RPP levels were well correlated with LVEF (r=− 0.26 and r= 0.14, respectively).DISCUSSIONThe results of this study suggest that resting plasma BNP level may be a useful clinical measure for evaluating both global functional capacity and myocardial specific work capacity in individuals with heart failure.