Correlation between microvascular dysfunction and B-type natriuretic peptide levels in non-ischemic heart failure patients with cardiac fibrosis
Correlation between microvascular dysfunction and B-type natriuretic peptide levels in non-ischemic heart failure patients with cardiac fibrosis
复制标题
DOI：
10.1016/j.ijcard.2016.11.054
复制
发表时间：
2017-02-01
影响因子：
3.5
通讯作者：
Tsujita, Kenichi
中科院分区：
文献类型：
--
作者：
Hirakawa, Kyoko;Yamamuro, Megumi;Tsujita, Kenichi
背景资料：心力衰竭（HF）患者心脏纤维化时微血管功能障碍与血浆B型利钠肽（BNP）水平的关系尚不清楚。方法：本研究评价了55例连续的非缺血性HF患者，旨在确定内皮非依赖性冠状动脉微血管功能障碍与血浆BNP水平之间的关系，以及是否每项指标与心肌纤维化相关。我们评估了稳定性HF患者的血浆BNP水平。我们使用心导管术测量经心脏BNP释放水平，从冠状窦和主动脉根测量，以及冠状动脉血流储备（CFR）。结果：心导管检查中CFR与血浆BNP水平（r = 0.336，p = 0.012）和经心脏BNP释放水平（r - 0.347，p - 0.041）呈显著负相关。33例患者为LGE阳性。在LGE阳性组中，CFR与血浆BNP水平显著相关（r = 0.349，p = 0.046），但在LGE阴性组中，这种相关性不显著。（r= 0.338，p = 0.125）。多因素Logistic回归分析显示，心衰稳定期血浆BNP水平>180 pg/ml是CFR < 2.5的独立预测因子（p = 0.035，比值比：5.2，95%置信区间：1.1-29.0），在LGE阳性组中（p= 0.040，比值比：5.4，95%可信区间：1.1-27.2）结论：在非缺血性心力衰竭患者中，尤其是那些伴有心脏纤维化的患者，内皮非依赖性微血管功能障碍与血浆BNP水平和心室壁张力密切相关。(C)2016爱思唯尔爱尔兰有限公司版权所有。
Backgrounds: The relationship between microvascular dysfunction and plasma B-type natriuretic peptide (BNP) levels remains unclear in heart failure (HF) patients with cardiac fibrosis.Methods: This study evaluated 55 consecutive non-ischemicHF patients in an effort to determine the relationship between endothelial independent coronarymicrovascular dysfunction and plasmaBNP levels, aswell aswhether each measure is correlated with myocardial fibrosis. We evaluated plasma BNP levels in patients with stable HF. We used cardiac catheterization to measure trans-cardiac BNP release levels, measuring from the coronary sinus and the aortic root, and coronary flow reserve (CFR). Patients also underwent cardiacmagnetic resonance imaging to evaluate for the presence of late gadolinium enhancement (LGE), as an indicator of cardiac fibrosis.Results: CFR in cardiac catheterization was significantly and inversely correlated with plasma BNP levels (r = 0.336, p = 0.012) and trans-cardiac BNP release levels (r - 0.347, p - 0.041). Thirty-three patients were LGE-positive. CFR was significantly correlated with plasma BNP levels in the LGE-positive group (r = 0.349, p = 0.046), but this correlation was not significant in the LGE-negative group. (r= 0.338, p = 0.125). Multivariate logistic regression analysis revealed that a plasma BNP levels >180 pg/ml at stable HF condition was significant and independent predictor of CFR < 2.5 in all patients (p = 0.035, odds ratio: 5.2, 95% confidence interval: 1.1-29.0), and in the LGE-positive group (p= 0.040, odds ratio: 5.4, 95% confidence interval: 1.1-27.2).Conclusions: In non-ischemic HF patients especially those with cardiac fibrosis, endothelial independent microvascular dysfunction is closely correlated with plasma BNP levels, and ventricular wall tension. (C) 2016 Elsevier Ireland Ltd. All rights reserved.