Relationship Between Plasma BNP Level And Changes Of Cardiac Structure And Function In Patients With Essential Hypertension

Objective:To investigate the relationship between plasma brain natriuretic peptide(BNP)level and cardiac structural and functional changes in patients with essential hypertension.Methods:320 patients with hypertension admitted to the Department of Cardiology,First Affiliated Hospital of Anhui Medical University from January 2017 to November 2018 were divided into simple hypertension group(control group)(n = 52),septal thickening group(n = 48),left ventricular wall thickening group(n = 40),left atrial enlargement group(n=46),left ventricular hypertrophy group(n=66),left atrial and left ventricular enlargement group(n = 68).The sex,age,smoking history,drinking history,diabetes history,fasting blood glucose,glycosylated hemoglobin,BNP level,left atrial diameter(LA),interventricular septal(IVS),left ventricular diameter(LVD),left ventricular ejection fraction(LVEF),left ventricular posterior wall(LVPW)of the subjects were recorded.To compare the differences of each index in six groups,and to analyze the correlation between these indexes and the changes of cardiac structure and function in patients with essential hypertension.Results:1.Compared with the control group,the age of each group of cardiac remodeling was older,and the age of the control group was significantly different from that of the interventricular septum thickening group,the left atrium enlargement group and the leftatrium and left ventricle enlargement group(P < 0.05).SBP in left atrial and left ventricular enlargement group was lower than that in the other five groups.There was no significant difference in sex,smoking,drinking,diabetes,DBP,FBG and Hb A1 c among the six groups(P>0.05).2.BNP,LA and LVD in each group of cardiac remodeling were higher than those in the control group,and BNP,LA and LVD increased with the severity of cardiac remodeling(P<0.001).The incidence of HFREF in left ventricular hypertrophy group and left atrial and left ventricular enlargement group was significantly higher than that in the other groups,and the incidence of HFREF in left atrial and left ventricular enlargement group was the highest,and higher than that in left ventricular hypertrophy group(P<0.05).3.Pearson correlation analysis was made between LVEF and plasma BNP level and cardiac structural parameters in each group of hypertensive cardiac remodeling.The results showed that there was no correlation between LVEF and IVS,LVPW in each group of hypertensive cardiac remodeling(P>0.05),but negative correlation between LVEF and BNP,LA and LVD(P<0.001).4.The diagnostic value of plasma BNP,LA and LVD for HFREF was compared by the area under ROC curve.AUC was 0.845(95% CI:0.801-0.890,P < 0.001),sensitivity 79.3%,specificity 76.8%,AUC was 0.725(95% CI: 0.668-0.781,P<0.001),sensitivity 77.2%,sensitivity 77.2%,specificity 62.7%,AUC was 0.940(95% CI:0.915-0.965,P<0.001),sensitivity89.1%,The specificity was 89.0%.When combined,AUC increased to 0.954(95% CI: 0.933-0.975,P < 0.001),sensitivity 94.6%,specificity 89.5%.Conclusion:1.Age is a risk factor for cardiac remodeling in patients with essential hypertension.2.The plasma BNP level has a good predictive value for the changes of cardiac structure and function in patients with essential hypertension.3.Combining BNP,LA and LVD can significantly improve the diagnosis of HFREF.