心力衰竭患者脑钠肽水平与左室舒张充盈类型及肺动脉收缩压的关系

目的研究收缩性心力衰竭患者左室舒张充盈类型及肺动脉收缩压与血浆脑钠肽(BNP)水平的相关性。方法61例收缩性心力衰竭患者(左室射血分数<50%)进行超声心动图检查,根据肺静脉血流和二尖瓣口舒张期血流评价左室舒张充盈类型,根据连续多普勒超声心动图收缩期三尖瓣口返流血液的峰值流速测肺动脉收缩压,同时进行血浆BNP水平的检测。结果多元线性回归分析表明,在收缩性心力衰竭患者中,左室舒张充盈类型及肺动脉收缩压对血浆BNP有显著影响。Spearman相关分析表明,血浆BNP水平与左室舒张充盈类型及肺动脉收缩压均有明显的相关性(P<0.01)。当左室舒张充盈类型由正常型到限制型逐渐递增时,血浆BNP水平也相应增高,且血浆BNP水平随着肺动脉收缩压的升高而增高。结论收缩性心力衰竭患者中,肺动脉收缩压及左室舒张充盈类型与血浆BNP水平密切相关,在实际工作中运用超声心动图判断心功能时除常规的指标外,还需考虑舒张充盈类型和肺动脉收缩压,以全面评价患者的心功能状态。

Relationship of plasma B-type natriuretic peptide level to left ventricular filling pattern and systolic pulmonary arterial pressure in patients with systolic heart failure

Objective To study correlations between plasma B-type natriuretic peptide(BNP) level and left ventricular filling pattern and systolic pulmonary arterial pressure in patients with systolic heart failure. Methods Comprehensive Doppler echocardiography were performed to assess left ventricular diastolic function,including transmittal diastolic flow,pulmonary venous flow and measured plasma BNP levels in sixty-one patients with systolic heart failure(LVEF<50%),and the maximal systolic pressure gradient between the right ventricle and right atrium was measured. Results The multiple linear regression analysis showed that the left ventricular filling pattern and systolic pulmonary arterial pressure were positively associated with median plasma BNP level. Median plasma BNP level elevated with the severity of left ventricular filling pattern, as well as the increasing of systolic pulmonary arterial pressure. There were significant correlations between BNP and these indexes(P<0.01). Conclusions Median plasma BNP level is obviously related to systolic pulmonary arterial pressure and left ventricular filling pattern. When estimating the heart function of patients,synchronously consider,the diastolic function and systolic pulmonary arterial pressure,besides conventional echocardiography indexes to roundly evaluate the heart function of patients.