Does the C-type natriuretic peptide have prognostic value in Chagas disease and other dilated cardiomyopathies
Does the C-type natriuretic peptide have prognostic value in Chagas disease and other dilated cardiomyopathies
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DOI：
10.1097/01.fjc.0000249892.22635.46
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发表时间：
2006-12-01
影响因子：
3
通讯作者：
Walther, Thomas
中科院分区：
文献类型：
--
作者：
Heringer-Walther, Silvia;Moreira, Maria da Consolacao V.;Walther, Thomas
心钠素（ANP）和脑钠素（BNP）是心力衰竭（HF）患者左心室功能和预后的重要神经激素指标。查加斯病（CD）由原生动物克氏锥虫引起。仍然是拉丁美洲HF的主要原因。我们评估了第三种利钠肽C型利钠肽（CNP）的血浆浓度是否对CD或其他扩张型心肌病（DCM）患者也具有诊断和预后作用。根据纽约心脏协会（NYHA）分级对患者进行细分。CNP浓度通过放射免疫测定法（Immunodiagnostik，本斯海姆，德国）测定。主要随访时间为31.4个月（范围13至54个月），19例患者死亡，11例患者接受心脏移植。CNP浓度仅在NYHA III级和IV级的DCM或CD患者中显著改变（P < 0.05）。超声心动图数据与CNP的Pearson相关性显示DCM患者仅与左室收缩末期容积相关（P = 0.03）。此外，CNP不能预测死亡率或心脏移植的必要性。我们的数据是第一个证明第三钠尿肽CNP在CD和其他DCM中的水平升高的数据。然而，ANP和BNP对这两种疾病的死亡率有很高的预测价值，CNP没有任何预测效力。
Atrial natriuretic peptides (ANP) and brain natriuretic peptides (BNP) are powerful neurohormonal indicators of left-ventricular function and prognosis in heart failure (HF). Chagas disease (CD) caused by the protozoan Trypanosoma cruzi. remains a major cause of HF in Latin America. We assessed whether the plasma concentration of the third natriuretic peptide, C-type natnuretic peptide (CNP), also has diagnostic and prognostic properties in patients with CD or other dilated cardiomyopathies (DCM).Blood samples were obtained from 66 patients with CD, 50 patients with DCM from other causes, and 30 gender- and age-matched healthy subjects. Patients were subdivided according to the New York Heart Association (NYHA) class. The CNP concentration was determined by radioimmunoassay (Immundiagnostik, Bensheim, Germany).The main duration of follow-up was 31.4 months (range 13 to 54 months), 19 patients had died and 11 patients received a heart transplant. CNP concentrations were only significantly altered in patients with DCM or CD of the NYHA classes III and IV (P < 0.05). The Pearson correlation of echocardiographic data with CNP revealed an association only with the left-ventricular end systolic volume (P = 0.03) in patients with DCM. Furthermore, CNP did not predict mortality or the necessity for heart transplant.Our data are the first to demonstrate the raised levels of the third natriuretic peptide CNP in CD and other DCM Whereas ANP and BNP have a high predictive value for mortality in both diseases, CNP is without any predictive potency.