The Relation Between Ventricular Remodeling And Dynamic Change Of B-type Natriuretic Peptide Levels In Patients With AMI

ObjectiveRecently the incidence of AMI per year is 0.2%～0.6% in our country.Although with the development of medical treatment and the decline of the mortality of AMI,AMI is still a big problem influencing people's health. How to evaluate the risk degree of survival patients and find people with high risk factors has big relations with reentry rate and livability. These years, some foreign studys shows that the level of BNP have close relation with left ventricular remodeling,left ventricle function and mortality of AMI.But there are few studys about BNP in our country. The most common method for diagnosis of left ventricular faiure is Doppler ultrasound.But it is not the best method for screening. In this study,by analysing the dynamic change of serum BNP levels in AMI patients, to value it's effect in left ventricular remodeling and left ventricular function and to find the measures to decrease BNP levels in order to improve it's prognosis.Materials and methodsWe chose 60 patients who were diagnosed as AMI in 24 hours from the time of attack according to WHO diagnosis criterion of AMI. All patients were not complicated with liver,kidney dysfunction and COPD.All patients in PCI group were performed PCI operation in 12hs.Blood samples from all patients with AMI, were taken for determination of BNP levels, in 24hs, 48hs, 72hs, and the seventh day. Cardiac ultrasound were performed in 7-10 days after onset of AMI to measure left ventricular diameter, end-systolic volume of LV (ESV), end-diastolic volume of LV (EDV) , eject fraction of LV (LVEF). The plasmic BNP was measured by ARCHITECTI2000 Analysis device and cardiac function and relevant indices were measured by PHILLIPS IE33 Doppler ultrasound instrument.SAS-V8 was used for statistical analysis.The comparision between group was examined by T test and x~2test. The level of significance was set to (P＜0.05).Results1. The changing levels of BNP in AMI patients illustrate a single peak curve. The peak time is in 48-72hs and the level is still above normal level(50-150pg/ml) after one week.2. The levels of BNP in 24hs, 2days, 3days and one week were positively correlated with EDV and ESV, Whereas negatively correlated with LVEF. The BNP level in 3days and one week had closer correlation with EDV, ESV and LVEF value.Conclusions1. The changing levels of BNP in AMI patients illustrate a single peak curve. The peak time is in 48-72hs, the level decreased greatly after one week but the level is still above normal level.2. The changes of BNP level in early stage had close correlation with left ventricular remodeling and left ventricular function at one week after AMI, the levels in 3days and 7days had the closest correlation.3. BNP is one of the most sensitive index which reflect the function of left ventricular contraction and left ventricular remodeling.