Detection of left ventricular enlargement and impaired systolic function with plasma N-terminal pro brain natriuretic peptide concentrations
Detection of left ventricular enlargement and impaired systolic function with plasma N-terminal pro brain natriuretic peptide concentrations
复制标题
DOI：
10.1067/mhj.2002.122168
复制
发表时间：
2002-05-01
影响因子：
4.8
通讯作者：
Hildebrandt, PR
中科院分区：
文献类型：
--
作者：
Groenning, BA;Nilsson, JC;Hildebrandt, PR
背景 脑末端和 N 末端脑钠肽前体 (NT-proBNP) 已被确定为有希望的心力衰竭标志物。然而，之前的研究表明，由于健康受试者和心力衰竭受试者之间的血浆水平范围存在显着重叠，因此它们的诊断能力可能不足以应用于临床实践。我们假设参考方法（左心室 [LV] 功能的超声心动图评估）的不精确性可能影响了这些早期研究的结果。因此，我们希望通过磁共振成像研究 NT-proBNP 作为心脏测量参考方法的诊断潜力。方法 对 48 名纽约心脏协会功能分类 II 至 IV 级稳定症状心力衰竭患者以及 20 名年龄匹配和性别匹配的健康对照受试者进行一次血液样本和磁共振成像检查。结果 NT-proBNP 与 LV 舒张末期相关（r = 0.69；P < .0001）和收缩末期（r = 0.73；P < .0001）容量指数、左室质量指数（r = 0.69；P < .0001）和左室射血分数（r = -0.75；P < .0001）。计算NT-proBNP检测左室舒张末期容积指数(>105 mL.m(-2)[cut-offl;敏感性/特异性,82%/87%)、左室收缩末期容积指数(>35 mL.m(-2);敏感性/特异性,86%/86%)、左室质量指数(>152 g.m(-2);敏感性/特异性，85%/86%）和左心室射血分数（
Background Brain- and N-terminal pro brain natriuretic peptide (NT-proBNP) have been identified as promising markers for heart failure. However, previous studies have revealed that they may hold insufficient diagnostic power for implementation into clinical practice because of a significant overlap in the range of plasma levels between healthy subjects and subjects with heart failure. We hypothesized that imprecision of the reference method lie, the echocardiographic evaluation of left ventricular [LV] function) may have affected results from those earlier studies. We therefore wanted to investigate the diagnostic potential of NT-proBNP with magnetic resonance imaging as the reference method for the cardiac measurements.Methods Forty-eight patients with stable symptomatic heart failure in New York Heart Association functional classifications II to IV were examined once with blood samples and magnetic resonance imaging along with 20 age-matched and gender-matched healthy control subjects.Results NT-proBNP was associated with LV end-diastolic (r = 0.69; P < .0001) and end-systolic (r = 0.73; P < .0001) volume indices, LV mass index (r = 0.69; P < .0001), and LV ejection fraction (r = -0.75; P < .0001). Receiver operating characteristic curves were calculated for the ability of NT-proBNP to detect LV end-diastolic volume index (>105 mL.m(-2)[cut-offl; sensitivity/specificity, 82%/87%), LV end-systolic volume index (>35 mL.m(-2); sensitivity/specificity, 86%/86%), LV mass index (>152 g.m(-2); sensitivity/specificity, 85%/86%), and LV ejection fraction (