The Clinical Meaning Of The Plasma B-type Natriuretic Peptid Testing In Hypertension With Left Ventricular Hypertrophy Occurred In Electrocardiogram

Objective:The purpose of this study was to analyze the clinical meaning of the plasma B-type natriuretic peptide(BNP) testing in hypertension with left ventricular hypertrophy (LVH) occurred in electrocardiogram(ECG).Methods:Sixty-eight patients were diagnosed with hypertensive heart disease by echocardiography from August 2008 to March 2010, including 40 males and 28 females, mean age was 64.5±11.7 years. These patients were divided into two groups according to if LVH occurred in ECG, or not, groupⅠ(LVH) and groupⅡ(no LVH). Admission B-type natriuretic peptide was measured by point-of-care and the hypertension history, symptoms, physical and chemical indicators,24-hour ambulatory blood pressure were evaluated, and some patients received coronary angiography examination, the data were analyzed by SPSS11.5 software.Results:The detected rate of LVH occurred in ECG in patients with hypertensive heart disease was 38.2%. The BNP level at admission was 57.60±18.70 pg/ml in groupⅠ, and 17.20±2.52 pg/ml in groupⅡ, the difference between two groups was statistically significant (P=0.009<0.05). In groupⅠ,20 patients, accounting for 76.9% and in groupⅡ,16 patients, accounting for 38.1% had the symptoms of chest tightness or chest pain respectively, the difference was statistically significant (P=0.040<0.05).18 cases in groupⅠ, accounting for 69.2% vs 9 cases in groupⅡ, accounting for 21.4% had paroxysmal nocturnal dyspnea (P=0.000<0.05); The hypertension history was 13.31±11.21 years in groupⅠvs 12.76±12.26 years in groupⅡ(P=0.854> 0.05). The systolic blood pressure was 170.19±26.70 mmHg, diastolic blood pressure was 91.54±15.41mmHg in groupⅠ and was 157.26±21.84 mmHg,91.67±10.52 mmHg in groupⅡ, the difference of systolic blood pressure between the two groups was statistically significant (P=0.033<0.05). The rate of non-dipper blood pressure was accounting for 70.6%in all patients, and accounting for 88.5% in groupⅠ, 52.1% in groupⅡwith 24-hour ambulatory blood pressure monitoring examination, the difference between two groups was statistically significant (P=0.023<0.05). Of the patients,33 cases received a coronary angiography, 19 cases in groupⅠ, accounting for 73.0% and 14 cases in groupⅡ, accounting for 33.3%. The slow blood flow phenomenon occurred in 9 cases in groupⅠ, accounting for 47.4%,1 case in groupⅡ, accounting for 7.1%, the difference between two groups was statistically significant (P=0.036<0.05).Conclusion:The BNP level at admission was significantly higher in the hypertension with LVH than with no LVH occurred in ECG. The long-term higher systolic blood pressure, non-dipper blood pressure and the dysfunction of microcirculation were maybe the main reasons in patients with hypertensive heart disease whose ECG occurs LVH and these patients have more severe diastolic dysfunction.