Plasma brain natriuretic peptide as an indicator of left ventricular systolic function and long-term survival after acute myocardial infarction - Comparison with plasma atrial natriuretic peptide and N-terminal proatrial natriuretic peptide
Plasma brain natriuretic peptide as an indicator of left ventricular systolic function and long-term survival after acute myocardial infarction - Comparison with plasma atrial natriuretic peptide and N-terminal proatrial natriuretic peptide
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DOI：
10.1161/01.cir.93.11.1963
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发表时间：
1996-06-01
期刊：
影响因子：
37.8
通讯作者：
Dickstein, K
中科院分区：
文献类型：
--
作者：
Omland, T;Aakvaag, A;Dickstein, K
背景：急性心肌梗死（AMI）后，血浆中心房利钠肽（ANP）和心房利钠肽原激素n端片段（N-ANP）水平升高与左心室功能下降和长期生存率降低有关。先前的数据表明，AMI和慢性心力衰竭后，血浆脑钠肽（BNP）可能比血浆ANP成比例地增加。相对于ANP和N-ANP，血浆BNP作为AMI后左室功能障碍和长期生存指标的诊断和预后价值有待确定。方法与结果131例AMI患者在症状出现后第3天取静脉血分析ANP、N-ANP和BNP。左心室射血分数通过超声心动图测定79例患者的亚样本。随访期间（中位1293天）发生28例心血管死亡和3例非心血管死亡。单变量Cox比例风险回归分析（ANP: P）证实，这三种多肽都是心血管死亡率的有力预测因子
Background Elevated plasma levels of atrial natriuretic peptide (ANP) and the N-terminal fragment of the ANP prohormone (N-ANP) are associated with decreased left ventricular function and decreased long-term survival after acute myocardial infarction (AMI). Previous data suggest that plasma brain natriuretic peptide (BNP) may increase proportionally more than plasma ANP after AMI and in chronic heart failure. The diagnostic and prognostic value of plasma BNP as an indicator of left ventricular dysfunction and long-term survival after AMI, relative to that of ANP and N-ANP, remain to be established.Methods and Results Venous blood samples for analysis of ANP, N-ANP, and BNP were obtained on day 3 after symptom onset from 131 patients with documented AMI. Left ventricular ejection fraction was determined by echocardiography in a subsample of 79 patients. Twenty-eight cardiovascular and 3 noncardiovascular deaths occurred during the follow-up period (median, 1293 days). All three peptides proved to be powerful predictors of cardiovascular mortality by univariate Cox proportional hazards regression analyses (ANP: P