A Study Of Diagnostic And Progostic Value Of BNP In Old People With Heart Failure

Objective To investigate the diagnostic and prognostic value of brain natiuretic peptide(BNP) in old people with heart failure (HF).Method Plasma BNP concentration were measured by a fluorescence immunoassay in normal controls(n=18), asymptomatic heart failure(aSHF) patients (n=21) and symptomatic heart failure(SHF) patients(n=41) . SHF patients were divided into class II group,class â…¢ group,class IV group according to the functional classification advised by New York Heart Association(NYHA). We compared the accuracy of heart functional classification of NYHA, LVEF and BNP with cardiovascular specialists classification. We measured some indices about left ventricular function (such as LVEF,LVEDD,LVESD,PASP,E/A) by ultrasonic cardiography for all subjects .The cardiovascular events were observed during hospitalization of all patients. Meanwhile, We compared their plasma BNP concentration and heart function indices.Results It shows that Plasma BNP concentration not only increase progressively in normal controls, aSHF group and SHF group (p<0.05), but also increase by degree in class II group , class â…¢ group and class IV group. When plasma BNP concentration is 70pg/ml, the sensitivity,specificity,nagative predicitive value,positive predictive value for diagnosis of aSHF are 90.48%,94.44%,90.48%,95 % respectively. The accuracy of heart functional classification of NYHA,LVEF and BNP compared with cardiovascular specialists classification are 72.6%,80.5%,83.2% respectively. Plasma BNP concentration has positive correlation with LVEDD,LVESD and PASP, and has negative correlate with LVEF, but it has not correlation with A/E. Their correlation coefficient are 0.48,0.60,0.55,-0.57,0.021 respectively. There are not obvious difference between the incidence rate of cardiovascular events of normal controls and the one of aSHF group (p>.05). But the incidence rate of cardiovascular events of class III group and class IV group are specially higher than normal controls and aSHF group (p<0.001). The plasma BNP concentration and LVEF of the patients who have cardiovascular events are also higher than that of the patients who have not (p<0.05). But There are not obvious difference between the two in LVEDD and LVESD (p>0.05).Conclusion:Plasma BNP concentration can reflect severity of heart failure. It is relative with heart fuction and has a good prognostic value in the near future for old people with heart failure. BNP might be a very important screening tool for the diagnosis of aSHF in clinical work.