Correlation Between Brain Natriuretic Peptide And Doppler In Diagnosis Of Diastolic Heart Failure

BackgroundsHeart failure is the development of a variety of terminal stages of cardiovascular disease, its morbidity and mortality rates were high. According to the changes in contractile function in heart failure congestive heart failure can be divided into systolic heart failure and diastolic heart failure. The past, a large number of clinical trials and research over the crowd for systolic heart failure, diastolic heart failure on the simple systematic study of population less information, so the latter diagnosis, clinical features, prognosis has not yet clarified.Diastolic heart failure (diastolic heart failure, DHF) because of its high incidence, and gradually become a research hotspot,。but is still a lack of evidence-based medicine proved effective in the treatment of drug treatment alone empirical. The diagnosis of diastolic heart failure has not been uniform。Recent studies have found that the quality of the blood concentration of NT-proBNP in heart failure patients with ventricular diastolic function feflects a number of echocardiographic indexes related, confirmed that the quality of plasma NT-proBNP concentrations can be a more reliable reflection of ventricular diastolic function in heart failure patients with fashion the advantages of a simple and easy to operate.Plasma brain natriuretic peptide concentration and Doppler ultrasound examination can be used as diastolic heart failure diagnosis and determine the severity of obj ective indicators.PurposeThis study was designed the clinical cardiovascular medicine inpatient venous plasma NT-proBNP level, at the same time echocardiography to measure left atrioventricular diameter, left atrial volume, left ventricular wall thickness, mitral flow velocity, pulmonary vein blood flow velocity and diastonic mitral annulus velocity, analysis and comparison of NT1 proBNP levels and diastolic function by echocardiography of the correlation between indicators, research their diagnosis of diastolic heart failure, as well as the correlation between them of. Materials and methods(A) the object of studySelected Clinical Hospital of Jilin University of Cardiology,2nd Hospital of diastolic heart failure (DHF) in patients with 58 cases,30 males and 28 females, aged between 40 and 82 years old, with an average age of 67.19 years.Diagnostic criteria of diastolic heart failure:The original incidence of coronary heart disease, hypertensive heart disease, hypertrophic cardiomyopathy, the typical symptoms of pulmonary congestion, signs and X-ray findings, systolic function and normal cardiac ultrasound or radiological examination of left ventricular blood pool imaging ejection fraction (LVEF)≥50%, with left ventricular dysfunction, or ventricular filling expansion rigid basis.Underlying disease:30 cases of coronary heart disease, hypertension and heart disease in 25 cases, hypertrophic cardiomyopathy in 3 cases. Based on the New York Society of Cardiology (N YHA) cardiac function classification,Ⅱgrade 327 cases,Ⅲgrade 19 cases,Ⅳgrade in 12 cases. Patients were excluded for more than a serious liver and kidney disease, primary aldosteronism, hyperthyroidism, cancer, did not take off within 2 weeks of aldosterone influence of drugs.Control group:no clinical manifestations of heart failure in hypertensive patients or patients with unstable angina pectoris, a total of 30 cases, male 17, female 13 cases, aged 45 to 75 years old (62 years±10 years).(B) MethodA plasma concentration of NT-BNP determination of selected objects in the 06: 00-07:00 pm quiet state of fasting venous blood taken elbow by adding EDTA anticoagulant test tube, centrifuge 15 min, taking the brain were measured in plasma using ELISA natriuretic peptide concentrations.2 Doppler ultrasound cardiac function parameters using the United States philips iu22 ultrasonic Doppler ultrasonic diagnostic apparatus, the probe frequency 2.5 MHz, simultaneously recorded echocardiography, the patient supine on the left, take left ventricular parasternal long axis view, using M-mode ultrasound measurement of left ventricular end-diastolic diameter (LV), left atrial diameter (LA), interventricular septum thickness (IVS) and left ventricular posterior wall thickness (LVPW), LVEF. Apical four-chamber aspect:The pulsed Doppler measurement of mitral diastolic flow spectrum, peak early diastolic velocity (E peak), peak late diastolic velocity (A peak) and E/A. Tissue Doppler imaging in the wall at the junction of mitral valve ring were measured early diastolic, late diastolic peak velocity (Em, Am), and calculate the E/ Em.(C) using SPSS statistical software industry 3.0 for statistical analysis of data measurement data to the mean±standard deviation indicated by linear correlation analysis of plasma NT 1 proBNP levels and echocardiographic parameters measured by the correlation between. P<0.05 indicated that the difference was statistically significantResultsPlasma brain natriuretic peptide concentration and the E/A ratio was negatively correlated (r=-0.634, P<0.01), and the E/Em ratio was positively correlated (r= 0. 728, P<0.01). ConclusionThe mass concentration of NT-proBNP in heart failure patients with ventricular diastolic function reflects a number of echocardiographic indexes related, confirmed that the quality of plasma NT-proBNP concentrations can be a more reliable reflection of ventricular diastolic function in heart failure patients. Of plasma brain natriuretic peptide concentration in the Joint Doppler ultrasound examination can be used as diastolic heart failure diagnosis and determine the severity of objective indicators.