Utility of B-natriuretic peptide in detecting diastolic dysfunction - Comparison with Doppler velocity recordings
Utility of B-natriuretic peptide in detecting diastolic dysfunction - Comparison with Doppler velocity recordings
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DOI：
10.1161/hc0502.103010
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发表时间：
2002-02-05
期刊：
影响因子：
37.8
通讯作者：
Maisel, AS
中科院分区：
文献类型：
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作者：
Lubien, E;DeMaria, A;Maisel, AS
背景：尽管多普勒超声心动图已被用于识别左心室舒张充盈动力学异常，但其固有的局限性表明需要对舒张功能障碍进行额外的测量。由于数据显示b -利钠肽（BNP）部分反映心室压力，我们假设BNP水平可以预测收缩功能正常患者的舒张异常。方法与结果：294例患者行超声心动图评价心室功能。排除有收缩功能异常的患者。评估左室功能的心脏病专家对BNP水平不知情。患者分为正常、松弛受损、假正常和限制性样充盈模式。诊断为左室舒张功能异常的患者（n=119）的BNP平均浓度为286+/-31 pg/mL；正常左室组（n=175） BNP平均浓度为33+/-3 pg/mL。超声心动图显示限制性样充盈型患者BNP水平最高（408 - 66 pg/mL），有症状的患者在所有舒张期充盈型中BNP水平均较高。BNP检测舒张功能障碍的受体-工作特征曲线下面积为0.92 (95% CI, 0.87 ~ 0.95
Background-Although Doppler echocardiography has been used to identify abnormal left ventricular (LV) diastolic filling dynamics, inherent limitations suggest the need for additional measures of diastolic dysfunction. Because data suggest that B-natriuretic peptide (BNP) partially reflects ventricular pressure, we hypothesized that BNP levels could predict diastolic abnormalities in patients with normal systolic function.Methods and Results-We studied 294 patients referred for echocardiography to evaluate ventricular function. Patients with abnormal systolic function were excluded. Cardiologists making the assessment of LV function were blinded to BNP levels. Patients were classified as normal, impaired relaxation, pseudonormal, and restrictivelike filling patterns. Patients diagnosed with evidence of abnormal LV diastolic function (n=119) had a mean BNP concentration of 286+/-31 pg/mL; those in the normal LV group (n=175) had a mean BNP concentration of 33+/-3 pg/mL. Patients with restrictivelike filling patterns on echocardiography had the highest BNP levels (408 66 pg/mL), and patients with symptoms had higher BNP levels in all diastolic filling patterns. The area under the receiver-operating characteristic curve for BNP to detect any diastolic dysfunction was 0.92 (95% CI, 0.87 to 0.95; P