The Change Of Cardiac Troponin â…  And Brain Natriuretic Peptide In Chronic Heart Failure Patients

Objective: Through observing the change of serum cardiac troponin I (cTnI) and blood plasma brain natriuretic peptide (BNP) in chronic heart failure patients , and investigating the correlation among cTnI, BNP, cardiac functional grade(NYHA) and ultrasound parameter ( LVEF,LVEDd,LADd),to explore the value of examination cTnI and BNP for evaluating cardiac function in chronic heart failure patients .Methods: According to the NYHA cardiac functional grading method, 63 patients of CHF were divided into three groups as follows: gradeⅡ, 15 cases; gradeⅢ, 25 cases; gradeⅣ, 25cases. The control group consisted of 20 normal subjects. Left ventricular ejection fraction ( LVEF ), left ventricular end-diastole diameter (LVEDd), left atrium diastole diameter(LADd) are determined by echocardiography, cTnI is measured by microparticle enzyme immunoassay(MEIA) technology in Abbott Axsym system in the next morning, at the same time ,BNP is measured by Triage? Meter Plus. The data is processed and analyzed through SPSS 11.5 statistics software.Results: 1. In 63 patients of CHF, 22 cTnI are detected(34.9%). In the 20 cases of control groups no cTnI are detected. The positive rate of detected cTnI has no significance (P>0.05) in different NYHA cardiac functional grade, or in different amplitude of LADd and LVEDd; The positive rate of detected cTnI within LVEF≤30% and >40% has significance (P=0.012);the comparasion of LADd, LVEDd and LgBNP between cTnI positive detected groups and negative groups has no significance(p>0.05), and the comparasion of LVEF between two groups has statistics significance(p<0.05). 2. The BNP value of cipher, quartile and extrame value of 2 ends are increasing with the NYHA cardiac functioanl grade development; and the correlation analysis displays BNP is positively correlated with cardiac functional grade, LVEDd and LADd respectively;BNP is negatively correlated with LVEF. The LgBNP in the patients groups of CHF has significant difference from that in the control groups(p<0.05).The LgBNP in patients of CHF is increasing with the aggravation of cardiac function;The LgBNP in control groups has a significant difference from all grades of cardiac functional groups(p<0.05). 3. The concentration of acidum uricum in patients of CHF is higher than that in the control group(P<0.05).That in cardiac function grade III, and IV has a significant difference from control group and cardiac function II(P<0.05)Conclusions: 1.Low concentration of cTnI can be detected in the patients of CHF, and the positive rate is increasing when LVEF is quite low. This indicates that CHF patients, especially those serious patients have chronic and continous myocardial damages. But this study doesn't make any conculsion that cTnI value is clearly correlated with cadiac funciton grade and ultrasound parameter. 2. The BNP in patient of CHF is correlated with NYHA cardiac functional grade, ultrasound parameter(LVEF,LVEDd,LADd); The BNP is increasing with the aggravation of cardiac function, which indicates that BNP is an idea index to diagnose CHF cases.