Relation of coronary atherosclerosis determined by election beam computed tomography and plasma levels of N-terminal pro-brain natriuretic peptide in a multiethnic population-based sample (The Dallas Heart Study)
Relation of coronary atherosclerosis determined by election beam computed tomography and plasma levels of N-terminal pro-brain natriuretic peptide in a multiethnic population-based sample (The Dallas Heart Study)
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DOI：
10.1016/j.amjcard.2005.06.073
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发表时间：
2005-11-01
影响因子：
2.8
通讯作者：
de Lemos, JA
中科院分区：
文献类型：
--
作者：
Abdullah, SM;Khera, A;de Lemos, JA
在心脏缺血的情况下，B 型利钠肽 (BNP) 和 N 末端 BNP 前体 (NT-pro-BNP) 血浆水平升高，并且与冠状动脉疾病患者的不良后果相关。导致冠状动脉疾病患者利钠肽升高的机制，包括冠状动脉粥样硬化本身的作用，尚未完全阐明。对达拉斯心脏研究中 2,445 名没有心力衰竭和肾功能不全的受试者进行了 NT-pro-BNP、电子束计算机断层扫描和心脏磁共振成像测量。电子束计算机断层扫描确定的冠状动脉钙化评分分为无（< 10）、轻度（10至< 100）、中度（≥ 100至< 400）和重度（≥ 400）。随着冠状动脉钙评分类别的增加，NT-pro-BNP 水平显着增加（趋势 p < 0.0001）。在根据年龄、性别、种族、体重指数、高血压、心肌梗塞病史、心绞痛、血管紧张素转换酶抑制剂的使用、P-阻滞剂的使用、左心室（LV）射血分数和左心室质量进行调整的多变量模型中，较高的冠状动脉钙评分仍然与较高的 log NT-pro-BNP 水平独立相关（p = 0.03）。这种关联在排除左心室射血分数低、左心室肥厚、心绞痛和心肌梗塞病史的患者的类似模型中持续存在。总之，这些发现支持冠状动脉粥样硬化可能直接影响心脏神经激素系统激活的假设。 (c) 2005 Elsevier Inc. 保留所有权利。
Elevated plasma levels of B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-pro-BNP) are seen in the setting of cardiac ischemia and are associated with adverse outcomes in patients with coronary artery disease. The mechanisms leading to natriuretic peptide elevation in patients with coronary artery disease, including the contribution of coronary atherosclerosis itself, have not been fully elucidated. Measurement of NT-pro-BNP, electron beam computed tomography, and cardiac magnetic resonance imaging were performed in 2,445 subjects from the Dallas Heart Study who were free of heart failure and renal insufficiency. Electron beam computed tomography- determined coronary artery calcium scores were categorized as none (< 10), mild ( 10 to < 100), moderate ( >= 100 to < 400), and severe ( >= 400). NT-pro-BNP levels increased significantly across increasing coronary artery calcium score categories (p < 0.0001 for trend). In multivariate models adjusted for age, gender, race, body mass index, hypertension, history of myocardial infarction, angina, angiotensin-converting enzyme inhibitor use, P-blocker use, left ventricular (LV) ejection fraction, and LV mass, higher coronary artery calcium scores remained independently associated with higher log NT-pro-BNP levels (p = 0.03). This association persisted in similar models excluding patients with low LV ejection fractions, LV hypertrophy, angina pectoris, and a history of myocardial infarction. In conclusion, these findings support the hypothesis that coronary atherosclerosis may directly influence the activation of the cardiac neurohormonal system. (c) 2005 Elsevier Inc. All rights reserved.