功能性二尖瓣返流对慢性心力衰竭患者临床预后的影响

目的探讨116例功能性二尖瓣返流(Mitral regurgitation MR)程度对慢性心力衰竭患者预后的影响。方法回顾性分析116例慢性心力衰竭伴MR患者,按返流程度轻度、中度、重度分三组,检测并分析治疗前后N_端脑钠肽前体(NT_pro BNP)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)测值。结果治疗前各组间NT_pro BNP、LVEDD值比较差异有统计学意义(P0.05);LVEF值在轻度组与中度组之间比较差异无统计学意义(P0.05),而在轻中度组与重度组之间比较差异有统计学意义(P0.05)。优化治疗后在轻度和中度组NT_pro BNP、LVEF值治疗前后比较差异有统计学意义(P0.05),轻度组LVEDD值治疗前后比较差异有统计学意义(P0.05)。重度组NT_pro BNP、LVEDD及LVEF值治疗前后比较差异均无统计学意义(P0.05)。不同病因心脏病MR程度比较差异无统计学意义(P0.05),高血压性心脏病、冠心病患者治疗前后MR程度比较差异有统计学意义(P0.05),而扩张型心肌病患者治疗前后MR程度比较差异无统计学意义(P0.05)。结论 MR是影响慢性心力衰竭治疗效果的重要因素,优化药物治疗对轻、中度MR者效果较好,对部分伴中度MR药物治疗后临床指标改善不明显和重度MR及扩张型心肌病伴MR者疗效欠佳。     

新疆地区二尖瓣反流发病情况和临床特征——单中心10年超声资料分析

目的:分析二尖瓣反流(mitral regurgitation, MR)患者患病率以及心脏彩超特点。方法:本研究为大样本单中心回顾性研究,连续入选2012年1月—2022年12月在新疆医科大学第一附属医院首次就诊行超声心动图的患者资料。基于心脏彩超结果,对MR患者资料进行分析,总结和归纳MR患病情况以及心脏彩超相关指标。结果:共纳入32个民族150 190例患者,MR患者的平均年龄为(61.90±15.05)岁,男女之比为1:1.5。共检出MR患者31 495例,检出率为20.97%,在MR患者中,轻度(1+)、中度(2+)、中-重度(3+)、重度(4+)的患病率分别为13.73%、2.9%、0.46%、0.56%,随着年龄的增长患病率有增高趋势。1+MR中女性在各个年龄组的患病率均高于男性(P<0.001)。不同民族间,维吾尔族3+以上反流占比最大,汉族占比最低。无论是退行性MR(DMR)还是功能性MR(FMR),左心房内径(LAD)、左心室舒张末期内径(LVDD)、左心室收缩末期内径(LVSD)、左室射血分数(LVEF)都与MR相关联(均P<0.001),其中随着LVE...     

急性心肌梗死患者二尖瓣返流与心血管事件发生率的相关性

目的研究急性心肌梗死(AMI)患者合并二尖瓣返流(MR)与心力衰竭等严重并发症和死亡率的相关性。方法选取109例AMI患者,住院期间行超声心动检查观察二尖瓣返流情况,测定左心室射血分数(LVEF)、左室舒张末期内径、左房内径,并观察心力衰竭和主要心脏不良事件发生率、住院心源性病死率。结果MR的发生率为46.8%,左室舒张末期内径、左房内径均显著高于非MR组(P<0.01),LVEF显著低于非MR组(P<0.01)。心功能不全(Killip分级Ⅱ～Ⅲ级)、主要心脏不良事件发生率MR组显著高于非MR组(P<0.01)。全部心源性病死率MR组高于非MR组(P<0.05)。结论AMI后合并MR者,心功能差,心力衰竭和主要心脏不良事件发生率高,住院心源性病死率高。     

老年心房颤动伴二尖瓣反流患者的临床特点和预后

目的:探讨老年心房颤动(房颤)伴功能性二尖瓣反流(MR)患者的临床特点和预后。方法:回顾性分析2012年8月—2019年12月于北京大学第一医院老年病内科住院并接受超声心动图检查的年龄≥65岁、房颤伴左房增大、二尖瓣运动及形态正常、MR患者的临床资料。根据MR程度,分为轻度、中度、重度3组,分析组间临床指标及超声心动图指标差异。随访记录全因死亡及因心力衰竭(心衰)再住院的事件,进行Kaplan-Meier生存分析和多因素Cox回归分析。结果:入选120例患者,中位年龄86岁。重度MR组女性、NYHAⅣ级占比明显高于轻度和中度MR,重度MR组左室射血分数明显低于轻度和中度MR组;重度MR组BMI明显低于轻度MR组;重度MR组脑钠肽、收缩期三尖瓣反流峰值速度、肺动脉收缩压明显高于轻度MR组。在中位时间为26个月的随访中,44例(38.9%)发生全因死亡,37例(32.7%)因心衰再住院。3组间全因死亡率、因心衰住院率有显著差异(Log Rank P=0.042、0.006)。随着MR程度增加,全因死亡率、因心衰再住院率增加(P0.05)。多因素COX回归分析显示,NHYA分级(HR:1.924,95%CI:1.293～2.863,P=0.001)、MR程度(HR:1.717,95%CI:1.032～2.856,P=0.037)与因心衰再住院相关。结论:老年房颤伴功能性MR患者,随着MR程度增加,全因死亡率、因心衰再住院率增加。NYHA分级、MR程度是老年房颤患者因心衰再住院的危险因素。     

经导管介入封堵动脉导管未闭合并功能性二尖瓣反流的近中期疗效评价

目的评价动脉导管未闭(PDA)合并中、重度功能性二尖瓣反流(MR)患者单纯行经导管介入封堵治疗的近中期疗效,探讨其可行性及安全性。方法回顾性分析2007年1月至2014年6月武汉亚洲心脏病医院PDA合并中、重度功能性MR并接受单纯行经导管介入封堵术的69例患者,其中男20例(29.0%),年龄24(4,45)岁。功能性MR中度45例(65.2%),重度24例(34.8%)。所有患者术后第1、3、6、12个月及之后每年复查超声心动图。评估MR、左心房(LA)直径、左心室(LV)直径、主肺动脉(MPA)直径、左心室射血分数(LVEF)等的变化。结果 69例患者中PDA漏斗型52例(75.4%),管型9例(13.0%),窗型8例(11.6%);PDA直径(8.19±2.64)mm,封堵器直径为(16.67±4.10)mm。手术成功率为100%,未见残余漏、封堵器移位等严重并发症发生。术后随访(15.91±17.73)个月。45例中度MR患者中20例减少为无反流,24例反流程度减少至轻度,1例仍为中度反流;24例重度MR患者中10例减少为无反流,10例反流程度减少至轻度,3例减少为中度反流,1例患者仍为重度反流。MPA直径[(2.54±0.78)cm比(3.27±1.11)cm,P0.001]、LA直径[(3.40±1.03)cm比(4.45±1.21)cm,P0.001]、LV直径[(4.76±1.16)cm比(6.26±1.45)cm,P0.001]均显著小于术前,差异均有统计学意义。将患者按不同年龄段分成3组:A组(0~13岁,26例)、B组(14~41岁,21例)、C组(42~64岁,22例),A组与B组、B组与C组改善率比较,差异均无统计学意义(均P0.05);而A组改善率(100.0%比81.8%,P=0.023)显著大于C组,差异有统计学意义。结论 PDA合并中、重度功能性MR患者在严格把握适应证的前提下单纯行经导管介入封堵术是安全有效的,MR程度均明显减轻,近、中期效果良好。     

功能性二尖瓣反流对非缺血性心肌病心脏再同步治疗患者反应性及长期预后的影响

目的:探讨术前功能性二尖瓣反流(FMR)及术后二尖瓣反流(MR)是否改善对非缺血性心肌病心脏再同步治疗(CRT)患者的反应性及长期预后的影响.方法:入选2010年1月-2017年6月首次接受CRT的非缺血性心肌病患者256例,根据基线MR程度分为无或轻度MR组(MR-组,73例)和中重度MR组(MR+组,183例).术...     

阻塞性睡眠呼吸暂停综合征患者左心室重构及血压分析

目的分析阻塞性睡眠呼吸暂停综合征(OSAS)患者的左心室重构和血压。方法选取2013年1月—2015年9月河南能源焦煤公司中央医院收治的OSAS患者126例,根据呼吸暂停低通气指数(AHI)分为轻度组(AHI 5~20次/h)、中度组(AHI 21~40次/h)及重度组(AHI40次/h),各42例。比较3组患者的多导睡眠监测指标、血压、心脏结构和功能指标。结果重度组患者的最长呼吸暂停时间(LAT)、平均呼吸暂停时间(AAT)、血氧饱和度低于90%的时间占整个睡眠时间的百分比(PSa O290)高于中度组和轻度组,睡眠过程中最低血氧饱和度(LSa O2)低于中度组和轻度组(P0.05);中度组患者的LAT、AAT、PSa O290高于轻度组,LSaO_2低于轻度组(P0.05)。重度组患者的收缩压、舒张压高于中度组和轻度组(P0.05);中度组患者的收缩压、舒张压高于轻度组(P0.05)。重度组患者左心房内径(LAId)、左心室舒张末期内径(LVEDd)、舒张期室间隔厚度(IVST)、左心房后壁厚度(LVPWT)、左心室质量(LVM)、左心室质量指数(LVMI)高于中度组和轻度组(P0.05);中度组患者的LAId、LVEDd、IVST、LVPWT、LVM、LVMI高于轻度组(P0.05)。结论随着OSAS患者病情的加重,其高血压、左心室肥厚及左心室舒张功能不全严重程度加重。     

不同程度功能性二尖瓣反流与射血分数降低心力衰竭患者预后相关性研究

目的观察不同程度功能性二尖瓣反流(FMR)对射血分数降低的心力衰竭(HFrEF)患者预后的影响。方法纳入2013年1月至 2019年9月期间于新疆医科大学第一附属医院心脏中心住院的HFrEF伴不同程度FMR患者818例, 中位随访24个月, 根据超声心动图FMR严重程度, 将患者分为轻度(118例)、中度(472例)、重度(228例)3 组。分析3组患者临床特点及随访期间主要复合终点(全因死亡和/或心力衰竭再入院)的发生率, 采用Kaplan-Meier生存曲线法比较三组患者生存情况。采用Cox风险比例回归模型分析HFrEF伴不同程度FMR患者罹患主要复合终点的影响因素。结果在24月随访期间, 共有376例(46.0%)研究对象发生主要复合终点, 其中死亡156例(19.4%), 因心衰再入院302例(36.9%)。随着FMR程度加重, 主要复合终点发生率升高(轻度、中度及重度FMR分别为 29.7%、46.0%及54.4%), 差异有统计学意义(P<0.01)。Kaplan-Meier生存分析结果显示, 轻度FMR患者的无事件生存率高于中、重度FMR患者(P<0.01)。...     

经导管主动脉瓣置入手术在主动脉瓣狭窄合并二尖瓣反流治疗中的疗效分析

目的:分析经导管主动脉瓣置入术在主动脉瓣狭窄合并二尖瓣反流(MR)的疗效。方法:选取我院就诊的主动脉瓣狭窄合并MR流患者31例,所有患者均行经导管主动脉瓣置入术,按照患者的MR流严重程度分为A组(轻度)和B组(中度、重度)。比较两组的并发症发生率、术后1个月的LVEF、LVEDD、MR和NYHA分级,比较两组在术后1个月、3个月时的死亡率和生活质量。结果:两组的各并发症发生率差异无统计学意义(P>0.05);A组在术后1个月时的LVEF和日常生活能力量表(ADL)评分均明显高于B组(P<0.05);A组在术后1个月时的死亡率、LVEDD、MR和NYHA分级明显低于B组(P<0.05);两组患者在术后3个月时的死亡率和ADL评分均差异无统计学意义(P>0.05)。结论:经导管主动脉瓣置入手术可用于主动脉瓣狭窄合并不同程度MR流患者的治疗中,反流的严重程度对患者远期死亡率和生活质量恢复的影响较小。     

彩色多普勒检测的二尖瓣返流与听诊和心音图的相关性研究

用彩色多普勒血流显像(CDFI)、心音图和心脏听诊,我们观察了108例病理性二尖瓣返流(MR)病人。根据 MR 的严重程度用 CDFI 分为轻、中和重度三组。三组病人间左心房(LA)大小有明显不同,MR的程度越重,LA 内径越大。CDFI 检出的 MR 与心杂音强度呈正相关(r=0.57,P<0.05)。心杂音对轻、中和重度 MR 的检出率分别为93％、95%和100%,优于心音图方法。     

Myocardial asynchronism is a determinant of changes in functional mitral regurgitation severity during dynamic exercise in patients with chronic heart failure due to severe left ventricular systolic dysfunction.

AIMS: Functional mitral regurgitation (MR) and myocardial asynchronism occur commonly in patients with dilated cardiomyopathy and affect adversely their prognosis and symptoms. The aim of this study was to evaluate the mechanisms of changes in MR severity during dynamic exercise in patients with chronic heart failure (CHF). METHODS AND RESULTS: Seventy patients with CHF due to left ventricular (LV) systolic dysfunction [LV ejection fraction (EF) <40%] and functional MR were studied. All were in sinus rhythm. Medications were left unchanged for the study. Each patient performed a maximal symptom-limited exercise test with continuous 2D-Doppler echocardiography. Mitral regurgitant volume (RV) and effective regurgitant orifice (ERO) were determined at rest and during exercise. LV asynchrony using Doppler tissue imaging and interventricular asynchrony using conventional pulsed-Doppler were evaluated at rest. Resting LV EF averaged 25+/-8%. Mean resting LV and interventricular mechanical delays were 56+/-50 and 43+/-37 ms, respectively. The overall median values for mitral ERO and RV did not significantly change during dynamic exercise (11 [7-16] vs. 11 [6-21] mm2 and 14 [10-22] vs. 12 [9-23] mL, respectively). However, changes in mitral ERO and RV were individually variable and significantly correlated with the degree of LV asynchronism (r=0.66, P<0.0001 and r=0.66, P<0.0001, respectively). CONCLUSION: Changes in MR are variable during dynamic exercise. LV asynchronism at rest substantially contributes to worsening of functional MR during dynamic exercise in patients with CHF due to LV systolic dysfunction.     

Differences in clinical profile and outcome in patients with decompensated heart failure and systolic dysfunction or preserved systolic function

OBJECTIVES: To compare the clinical characteristics and short- and long-term prognosis for chronic heart failure with left ventricular systolic dysfunction or preserved systolic function. PATIENTS AND METHOD: Three-hundred twenty-eight consecutive patients with decompensated chronic heart failure were studied prospectively. Depending on ejection fraction, participants were classified as having systolic dysfunction (group 1, ejection fraction < or = 40%,) or preserved systolic function (group 2, ejection fraction >40%). RESULTS: Systolic dysfunction was detected in 192 patients (58.5%) and preserved systolic function in 41.5%. Mean age was 62.7 (12.5 years) in group 1 and 65.2 (16.2 years) in group 2 (P=.03), with a male prevalence of 73.3% and 49.3%, respectively (P<.001). Ischemic cardiomyopathy was more frequent in group 1 (44.8% vs 25%; P<.001). Physical examination and electrocardiogram findings were similar in both groups, except for a higher proportion of patients in group 1 with a heart third sound (43.2% vs 25%; P=.001) and left bundle branch block (40.6% vs 15.4%; P<.001) and abnomal Q waves (31.3% vs 20.6%; P=.04). In-hospital mortality was similar in patients with systolic dysfunction and preserved systolic function (2.9% vs 1%; P=NS). Twenty-four-month cumulative survival was 61% for patients with systolic dysfunction and 76% for patients with preserved systolic function (log rank test P=NS). In the Cox proportional hazards model, which included age, sex, functional class, hepatomegaly, peripheral hypoperfusion, BUN, sodium level, ejection fraction > 40%, and biventricular heart failure, preserved systolic function was not associated with late mortality. The variables that were independent predictors of late mortality were peripheral hypoperfusion (OR = 3.7; P<.0001), low sodium level (OR=0.9; P=.009) and male sex (OR=1.9; P=.041). CONCLUSIONS: Decompensated chronic heart failure with preserved systolic function was more frequent in women and older patients. Patients with preserved systolic function had a lower prevalence of coronary heart disease. However, these differences had no impact on the short- and long-term prognosis.     

Catheter-based intervention for symptomatic patient with severe mitral regurgitation and very poor left ventricular systolic function - Safe but no room for complacency

Many patients with left ventricular systolic dysfunction have concomitant mitral regurgitation (MR). Their symptoms and prognosis worsen with increasing severity of MR. Percutaneous MitraClip^® can be used safely to reduce the severity of MR even in patients with advanced heart failure and is associated with improved symptoms, quality of life and exercise tolerance. However, a few patients with very poor left ventricular systolic function may experience significant haemodynamic disturbance in the peri-procedural period. We present three such patients, highlighting some of the potential problems encountered and discuss their possible pathophysiological mechanisms and safety measures.     

Functional mitral regurgitation during exercise in patients with heart failure.

BACKGROUND: Functional mitral regurgitation (MR) is common in patients with chronic heart failure (CHF) and left ventricular dysfunction. The severity of CHF is expressed in terms of exercise tolerance, so MR during exercise would affect the severity of heart failure. However, it is not well known how much MR increases during exercise, or if it is related with severity of heart failure. METHODS AND RESULTS: Seventeen subjects underwent dynamic cycle exercise at steady-state levels of 80% and 150% of anaerobic threshold (AT). During each exercise level, the MR jet and left atrial (LA) area were measured, and the degree of MR was expressed as the ratio (MR/LA). The MR/LA increased slightly at 80% AT (rest: 15.5+/-7.8%, 80% AT: 21.7+/-9.3%, p<0.05). It increased more at 150% AT (29.2+/-11.6%, p<0.01). The MR/LA at both 80% and 150% AT weakly correlated with peak oxygen consumption/heart rate (r=-0.509). They showed a weakly positive correlation with the ventilatoly equivalent/CO(2) production slope (r=0.340). CONCLUSIONS: MR during exercise increases as stroke volume worsens during exercise, so evaluation of MR during exercise is important in the management of patients with CHF.     

Heart Rate Variability in Chronic Heart Failure and Its Role in Prognosis of the Disease

Aim. To assess role of 24 hour heart rate variability (HRV) for prognosis of patients with chronic heart failure (CHF) and systolic dysfunction in the era of wide use of b-adrenoblockers. Material. Patients (n=135) with symptomatic CHF and ischemic (68%) or nonischemic cardiomyopathy (32%) with systolic left ventricular (LV) dysfunction and sinus rhythm (age 52+/-11.9 years; 42, 40 and 18% with NYHA class II, III and IV, respectively; mean LV ejection fraction 30.1+/-6.7%) At study entry 89 and 78% of patients received angiotensin converting enzyme inhibitors and b-adrenoblockers, respectively. Methods. Holter ECG monitoring with HRV temporal and spectral analysis. Results. During average follow-up of 2.4 years 60 patients (44.4%) died of cardiac causes (92.3% of all deaths). Other deaths were due to surgical pathology (n=1) and stroke (n=2). All standard HRV values with the exception of high frequency power were lowered, this lowering correlated with functional severity of heart failure. According to multifactorial analysis the following characteristics were independent predictors of all cause death: NYHA class III-IV (RR=1.9, 95% confidence interval 1.1-9.6, p=0.002), and SDNN value 90 ms (RR=1.5, 95% confidence interval 1.2-2.5, p=0.001). Conclusion. In CHF parameters of HRV are lowered compared to normal values and correlate with functional heart failure severity. NYHA class III-IV and lowered HRV (SDNN 90 ms) allow to identify patients with high risk of death.     

Plasma connective tissue growth factor is a novel potential biomarker of cardiac dysfunction in patients with chronic heart failure

BACKGROUND: Connective tissue growth factor (CTGF) has been recently reported as a mediator of myocardial fibrosis; however, the significance of plasma CTGF concentration has not been evaluated in patients with heart failure. The aim of this study was to investigate the clinical utility of plasma CTGF concentration for the diagnosis of heart failure. METHODS AND RESULTS: We evaluated fifty-two patients with chronic heart failure. The plasma concentration of CTGF and other markers of fibrosis were assessed and compared with clinical and echocardiographic data. Plasma CTGF was significantly elevated in symptomatic patients in proportion to their NYHA classes and was significantly correlated with plasma brain natriuretic peptide (BNP) concentration (r=0.395, P<0.01). Plasma CTGF was also correlated with plasma transforming growth factor beta (TGF-beta) (r=0.512, P<0.01), matrix metalloproteinase (MMP)-2 (r=0.391, P<0.05) and tissue inhibitor of MMP (TIMP)-2 (r=0.354, P<0.05) concentrations. Interestingly, plasma CTGF was correlated with E/E' value evaluated by tissue Doppler echocardiography (r=0.593, P=0.012), but not with systolic function and left ventricular mass. CONCLUSION: Our study suggests that plasma CTGF concentration is a novel diagnostic marker for cardiac dysfunction and may provide additional specific information about myocardial fibrosis in chronic heart failure patients.     

左室射血分数正常的心力衰竭患者的临床特点及左室收缩功能

目的 应用超声测量左室射血分数(LVEF)正常的心力衰竭(心衰)患者的房室平面位移,观察该类患者是否存在心室长轴方向收缩功能异常.方法 收集住院心衰患者96例,LVEF正常心衰组和LVEF降低心衰组各48例,50例健康体检者入选为对照组.比较各组在NYHA心功能分级、基础病因、房室平面位移、血浆N末端B型利钠肽原浓度的差异.结果 LVEF正常心衰组和LVEF降低心衰组的NYHA心功能分级差异无统计学意义.LVEF正常心衰组常见病因为高血压性心脏病和冠心病.对照组、LVEF正常心衰组、LVEF降低心衰组的房室平面位移依次下降.房室平面位移与血浆N末端B型利钠肽原水平负相关(r=-0.35,P<0.05).结论 通过传统方法测定的LVEF正常心衰组患者存在心室长轴方向上的收缩功能异常,而非单纯的舒张性心衰.     

Mitral regurgitation in patients with advanced systolic heart failure

BACKGROUND: Mitral regurgitation (MR) may develop in patients with advanced systolic congestive heart failure (CHF) without organic mitral valve disease and contribute to worsening symptoms and survival. Surgical mitral annuloplasty improves symptoms in patients with advanced CHF, and percutaneous approaches to mitral annuloplasty are being developed. Our objective was to define the prevalence, clinical correlates, and prognostic implications of functional MR and the use of mitral annuloplasty in patients with advanced systolic CHF evaluated in a heart failure clinic. METHODS AND RESULTS: We reviewed clinical, echocardiographic, and survival data from all patients with advanced systolic CHF (New York Heart Association class III or IV; ejection fraction 相似文献   

Relation of frequency and severity of mitral regurgitation to survival among patients with left ventricular systolic dysfunction and heart failure

The goal of this study was to examine the frequency of mitral regurgitation (MR) in patients with left ventricular (LV) systolic dysfunction and to relate its presence and severity to long-term survival. Remodeling of the left ventricle after myocyte injury leads to a progressive change in LV size and shape, and it may lead to the development of MR. The frequency of MR and its relation to survival in patients with LV systolic dysfunction has not been completely characterized. We analyzed the histories, coronary anatomy, and degree of MR in patients with symptomatic heart failure and LV ejection fraction <40% who underwent cardiac catheterization between 1986 and 2000. Cox's proportional hazards modeling was used to assess the independent effect of MR on survival. Two thousand fifty-seven patients met study criteria; MR was common in this cohort (56.2%). Of patients with MR, 811 (70.1%) had mild (grades 1+ or 2+) and 345 (29.8%) had moderate or severe (grades 3+ or 4+) regurgitation. Survival rates at 1, 3, and 5 years were significantly lower in patients with moderate to severe MR versus those with mild or no MR (p <0.001). MR was found to be an independent predictor of mortality after multivariable analysis (hazards ratio 1.23, 95% confidence interval 1.13 to 1.34, p = 0.0001). This relation of MR and survival was present in those with ischemic and nonischemic cardiomyopathies. MR is common in patients with LV systolic dysfunction and heart failure. After adjusting for other clinical variables, the presence of MR independently predicted worsened survival.     

血浆脑钠肽水平与心力衰竭病人心功能的关系

目的研究心力衰竭病人血浆脑钠肽(BNP)水平与心力衰竭严重程度、左室功能等因素的关系.方法采用化学发光免疫分析法测定80例心力衰竭病人BNP水平,用心脏彩色多普勒超声仪测定其左室功能.结果 BNP水平随着心功能纽约分级(NYHA)程度的加重而显著增加,其与左室射血分数(LVEF)呈负相关(r=-0.407,P＜0.01),与LVEDD、LVMI呈正相关,相关系数分别为r=0.351(P＜0.01)、r=0.369(P＜0.05).结论心力衰竭病人血浆BNP水平随着心力衰竭严重程度的增加而升高,并能较好地反映左室功能状态.