心脏再同步化治疗后血浆NT-ProBNP水平变化观察

目的:研究心脏再同步化治疗(cardiac resynchronization therapy,CRT)前后血浆前体脑钠肽(NT-ProBNP)水平的变化是否能够反映CRT植入后心衰患者心脏结构和功能改善程度。方法:对本中心33例植入CRT/CRT-D患者的随访资料进行分析,随访时间均>6个月,根据治疗效果将患者分为有反应组和无反应组,有反应者定义为术后左室收缩末容积缩小≥15%,心功能分级NYHA下降≥1级;无反应者为术后左室收缩末容积缩小<15%,NYHA下降<1级、因心衰再入院或心源性死亡。结果:有反应组术后NT-ProBNP水平明显降低(2.90±0.57)ng/L vs(3.38±0.47)ng/L,P=0.001]。随访时间≥6个月时,NT-ProBNP水平的降低幅度(ΔNT-ProBNP%)与左室舒张末容积缩小幅度(ΔLVEDV%)呈线性回归(b=-0.499,R2=0.489,P=0.001);无反应组术后NT-ProBNP与术前相比无显著性差别(3.53±0.42)ng/L,P>0.05];NT-ProBNP水平的变化与ΔLVEDV%无线性回归关系(P>0.05)。结论:CRT/CRT-...

The change of plasma N-terminal brain natriuretic peptide (BNP) level in the heartt failure patients after cardiac resynchronization therapy

Objective:To investigate if the change of N-terminal Brain natriuretic peptide(NT-ProBNP) level with the effect of cardiac resynchronization therapy(CRT). Methods:A retrospective review on 33 patients with CRT/CRT-D during 2005-2009 was conducted. Patients have been followed up for at least 6 months. The patient whose left end-systolic volume decreased by 15% after implantation was considered as responder to CRT. Results:After the implantation, the level of NT-ProBNP decreased significantly in the respond(2.90±0.57)ng/L vs (3.38±0.47)ng/L,P=0.001], which was in linear regression relationship with the variation of left ventricular end-diastolic volume(b=-0.499,R2=0.489,P=0.001). However, there was no such linear regression relationship existed in non-responder group. The reduction of NT-ProBNP level more than 13% predicted a responsive CRT(HR=14,P=0.02). Conclusion:The reduction of the plasma NT-ProBNP level more than 13% can predict CRT responsiveness. The change of plasma NT-ProBNP level is valuble to monitor of CRT effect.