B-type natriuretic peptide release and left ventricular filling pressure assessed by echocardiographic study after subarachnoid hemorrhage: a prospective study in non-cardiac patients.
B-type natriuretic peptide release and left ventricular filling pressure assessed by echocardiographic study after subarachnoid hemorrhage: a prospective study in non-cardiac patients.
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DOI：
10.1186/cc7891
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
Palmier B
中科院分区：
文献类型：
--
作者：
Meaudre E;Jego C;Kenane N;Montcriol A;Boret H;Goutorbe P;Habib G;Palmier B
蛛网膜下腔出血 (SAH) 后血清 B 型钠尿肽 (BNP) 经常升高，但这种高 BNP 水平是否与左心室充盈压 (LVFP) 短暂升高有关尚不清楚。然而，对于既往患有心脏病的患者，无法区分慢性心脏异常引起的 BNP 升高和与急性神经心脏损伤相关的 BNP 升高。所有入住我们重症监护病房的成年 SAH 患者均符合资格。患者因以下原因被排除：动脉瘤破裂后入院 >48 小时、既往患有高血压或心脏病。连续 7 天每天测量 BNP 和心肌肌钙蛋白 Ic 的水平。超声心动图由盲法心脏病专家在第 1、2 和 7 天进行。获得来自二尖瓣流入的多普勒信号、组织多普勒和彩色 M 模式衍生的血流传播速度 (FPV)，以评估回声估计的 LVFP。 3 年期间，连续收治了 66 名 SAH 患者。对 31 名患者进行了研究。前 3 天内，25 名患者 (80%) 的 BNP 水平 >100 ng/L，第 2 天达到峰值（中位值 126 ng/L），随后逐渐下降（第 1 至 7 天的中位变化，70%）。所有患者的射血分数均>50%。早期二尖瓣速度/组织多普勒二尖瓣环舒张早期速度较低：第 1 天为 5.4 (± 1.5)，第 2 天为 5.8 (± 1.2)，第 7 天为 5.1 (± 0.9)。早期二尖瓣速度/FPV 也较低：1.27 (± 0.4)、1.25 (± 0.3) 和 1.1 (± 0.3)。 0.2）分别在第 1、2 和 7 天。心肌肌钙蛋白 Ic 水平范围为 0 至 3.67 μg/L，与 BNP 相关（r = 0.63，P < 0.01）。 SAH 后，BNP 在两天内逐渐升高，并在一周内恢复正常。其释放与心肌坏死相关，但与超声心动图评估的 LVFP 升高无关。
Serum B-type natriuretic peptide (BNP) is frequently elevated after subarachnoid hemorrhage (SAH), but whether this high BNP level is related to transient elevation of left ventricular filling pressure (LVFP) is unknown. However, in patients with preexistent cardiac pathologies, it is impossible to differentiate between BNP elevation caused by chronic cardiac abnormalities and BNP related to acute neurocardiac injury. All adult patients with SAH admitted to our intensive care unit were eligible. Patients were excluded for the following reasons: admission >48 hours after aneurysm rupture, pre-existing hypertension, or cardiac disease. Levels of BNP and cardiac troponin Ic were measured daily for 7 days. Echocardiography was performed by a blinded cardiologist on days 1, 2, and 7. Doppler signals from the mitral inflow, tissue Doppler, and the color M-mode–derived flow propagation velocity (FPV) were obtained to assess echo-estimated LVFP. During a 3-year period, sixty-six consecutive patients with SAH were admitted. Thirty one patients were studied. The BNP level was >100 ng/L in 25 patients (80%) during the first 3 days, with a peak on day 2 (median, 126 ng/L) followed by a gradual decrease (median variation days 1 to 7, 70%). All patients had an ejection fraction >50%. Early transmitral velocity/tissue Doppler mitral annular early diastolic velocity was low: 5.4 (± 1.5) on day 1, 5.8 (± 1.2) on day 2, and 5.1 (± 0.9) on day 7. Early transmitral velocity/FPV was also low: 1.27 (± 0.4), 1.25 (± 0.3), and 1.1 (± 0.2) on days 1, 2, and 7, respectively. Cardiac troponin Ic levels ranged from 0 to 3.67 μg/L and were correlated with BNP (r = 0.63, P < 0.01). BNP rises gradually over two days and return to normal within a week after SAH. Its release is associated with myocardial necrosis, but is unrelated to elevated LVFP assessed by echocardiography.
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影响因子：
39.3
作者：
Bassan, R;Potsch, A;Moutinho, MA
通讯作者：
Moutinho, MA
DOI：
10.1016/s0735-1097(96)00496-2
发表时间：
1997-02-01
影响因子：
24
作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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影响因子：
2.8
作者：
Palazzuoli, Alberto;Deckers, Jaap;Puccetti, Luca
通讯作者：
Puccetti, Luca
影响因子：
4.8
作者：
Prasad, Abhiram;Lerman, Amir;Rihal, Charanjit S.
通讯作者：
Rihal, Charanjit S.