The Correlative Study Of The Level Of The Blood NT-proBNP With The Echocardiographic Parameters In Emergency PCI Patients

BackgroundWith the changes in people’s life, the prevalence and mortality of acute myocardial infarction became younger in recent years. Its complications threat the survival of the people and their quality of life. Launching of emergency coronary artery intervention treatment significantly reduced the mortality and complications in patients with acute myocardial infarction. Recanalizing the infarct-related artery (IRA) and saving the dying myocardial presents a time-dependent manner. There is not yet a clear blood biochemical indicator to evaluate the therapeutic effect of AMI patients with early and late prognosis after emergency PCI treatment, excepting muscle perfusion grading and application of echocardiography.Clinical studies have been shown that the NT-proBNP levels increased after the onset of ischemia. In AMI, NT-proBNP levels on the assessment value of interventional treatment and the prognosis information of the NT-proBNP provided,which is superior to and beyond the echocardiography or not, Still needs a large number of prospective studies to further prove.ObjectiveTo provide reference for clinical diagnosis and treatment of acute myocardial infarction through messuring the levels of plasma N-terminal pro-B-type Natriuretic Peptide and echocardiographic parameters at different time points before and after treatment in AMI patients with acute ST-segment, analysing the concentration of NT-proBNP as well as the correlation between ultrasound echocardiography and NT-proBNP in patients after emergency percutaneous coronary intervention (PCI), investigating the clinical significance of urgent intervention and whether the NT-ProBNP is able to predict ventricular changes in the structure and heart function in AMI patients.Methods1.60cases of AMI from January2011to March2012in department of cardiology Xinxiang Central Hospital were enrolled and divided into two groups:the primary PCI group and intravenous thrombolysis group. To select30primary PCI patients as the experimental group with an average age of57.40±10.74(28-74years old), including male20cases and female10cases. To select30intravenous thrombolysis patients as the control group with an average age of61.10±10.77(32-72years old), including the male22cases and female8cases.2. All patients were extracted elbow venous blood3ml immediately and24hours、3days.7days after diagnosis of AMI. The blood was put into the test tube containing heparin, High-speed separated and stored at20℃refrigerator. NT-proBNP was detected by the electrochemiluminescence double antibody sandwich immunoassay determination. The concentration of Blood NT-proBNP in control group was detected by the same method.3. To collect the Clinical data including acquisition history, symptoms,physical sign, diagnosis, heart function assessment,biochemical examination and echocardiographic parameters4. All data was analysied by SPSS17.0Results1. The blood level of NT-proBNP in two groups was no significant difference Before treatment (P>0.05); The24h、3d and7d NT-proBNP in emergency PCI group after treatment was significantly lower comparing with the control group (P<0.05).2. In Emergency PCI group after the treatment of1week, the echocardiographic figure parameters LVESD, LVEDD was lower than the control group (P<0.05, P<0.05); the echocardiography parameters LVEF was higher than the control group (P<0.05). In Emergency PCI group after the treatment of6months, the echocardiographic Figure parameters LVESD, LVEDD was significantly lower than the control group (P<0.01, P<0.01); the echocardiography parameters LVEF was significantly higher than the control group (P<0.01).3. The echocardiography parameters LVEF detected in1week was negativly correlated with the24h、3d and7d NT-proBNP in acute phase (P<0.05). The echocardiography parameters LVEF detected at6months was negativly correlated with the7d NT-proBNP, the partial correlation coefficient rp=-0.64,(P<0.01),4. The24h NT-proBNP concentration was positivly correlated with LVEDD detected in1week and6months, the partial correlation coefficient was rp=0.33,(P<0.01), rp=0.34,(P<0.01). The7d NT-proBNP concentration was positivly correlated with LVEDD detected in1week and6months,the partial correlation coefficient rp=-0.318,(P<0.01), rp=-0.409,(P<0.01),but no correlation with the NT-proBNP detected at other time points.Conclusions1. The results of two groups showed that the plasma level of NT-ProBNP increased in AMI patients. NT-proBNP level gradually decreased after treatment, in addition, NT-proBNP level decreased more in emergency PCI group than the other group.2. The Plasma NT-ProBNP level decreased significantly after primary PCI treatment in patients with AMI. Plasma NT-ProBNP level is one of important indicators used in the evaluation of the therapeutic effect of primary PCI.3. The plasma NT-proBNP levels was negatively correlated with LVEF, but positively correlated with LVEDD.The increasing level of NT-ProBNP is an important reference for the change of ventricular structure and cardiac function in AMI patients.