N-terminal pro B type natriuretic peptide, but not the new putative cardiac hormone relaxin, predicts prognosis in patients with chronic heart failure
N-terminal pro B type natriuretic peptide, but not the new putative cardiac hormone relaxin, predicts prognosis in patients with chronic heart failure
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DOI：
10.1136/heart.89.8.879
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发表时间：
2003-08-01
期刊：
影响因子：
5.7
通讯作者：
McMurray, J
中科院分区：
文献类型：
--
作者：
Fisher, C;Berry, C;McMurray, J
目的：探讨新的心脏激素松弛素对慢性心力衰竭(CHF)患者临床预后的预测作用。设计：对87例因左心收缩功能不全所致CHF急诊入院患者的血浆松弛素和N末端B型利钠肽(NT ProBNP)进行检测。地点：英国格拉斯哥西部医院。主要观察指标：血浆松弛素和NT-BNP原浓度；因心力衰竭而死亡或住院的时间。结果：血浆松弛素和NT-Pro-BNP浓度均显著升高。在43例NT Pro BNP高于中位数浓度的患者中，23例(53%)死亡，30例(70%)死亡或因CHF住院。在浓度低于中位数的44个国家中，这些数字分别为5个(11%)和12个(27%)(P<；0.0001和P<；0.0001)。在多变量分析中，血浆NT Pro BNP浓度仍然是不良临床结局的独立预测因子。在42名松弛素血浓度高于中位数的患者中，13名(31%)死亡，20名(48%)死亡或住院。低于中位数，这些数字分别为15/45(33%)和22/45(49%)(p=0.76和p=0.84)。结论：NT proBNP是CHF预后的一个强有力且独立的预测因子，而CHF患者心脏分泌的松弛素不是。
Objective: To determine whether the plasma concentration of the putative new cardiac hormone relaxin is predictive of clinical outcome in patients with chronic heart failure (CHF).Design: Plasma relaxin and N-terminal pro B type natriuretic peptide (NT pro BNP) concentrations were measured in 87 patients admitted in an emergency with CHF caused by left ventricular systolic dysfunction. These were related to death and death or readmission with CHF over the following year.Setting: Western Infirmary, Glasgow, UK.Main outcome measures: Plasma concentrations of relaxin and NT pro BNP; time to death or hospitalisation caused by heart failure.Results: Plasma concentrations of both relaxin and NT pro BNP were greatly increased. Of the 43 patients with NT pro BNP above the group median concentration, 23 (53%) died and 30 (70%) died or were hospitalised with CHF. Among the 44 with concentrations below the median, these numbers were 5 (11%) and 12 (27%), respectively (p < 0.0001 and p < 0.0001, respectively). Plasma NT pro BNP concentration remained an independent predictor of an adverse clinical outcome in a multivariate analysis. Of the 42 patients with a relaxin concentration above the median, 13 (31%) died and 20 (48%) died or were hospitalised. Below the median, these numbers were 15 of 45 (33%) and 22 of 45 (49%) (p = 0.76 and p = 0.84, respectively).Conclusions: NT pro BNP is a powerful and independent predictor of outcome in CHF, whereas relaxin, also secreted by the heart in increased amounts in CHF, is not.