The Serum Concentration Of Brain Natriuretic Peptide, Endothelin-1 Levels, Pulmonary Artery Pressure In Patients With Left Heart Failure

Objective To study the changes of serum brain natriuretic peptide (BNP), endothelin-1 (ET-1) levels, pulmonary artery pressure (PAP) and their correlation with left heart function in patients with coronary heart disease.Methods We enrolled one hundred and sixty-six consecutive patients diagnosed chronic heart failure (CHF) with coronary artery disease in our department, and thirty patients without chronic heart failure were enrolled randomly in control group. The patients who suffered from hematologic disease, connective tissue disease, malignant tumor, acute myocardial infarction or severe insufficiency of function in liver and kidney were all excluded. Upon entry the study, BNP and ET-1 levels were measured by enzyme-linked immunosorbent assay (ELISA), simultaneously, the detailed clinical feature, laboratory index and the result of auxiliary examination were recorded at the time of peripheral blood sampling. Left ventricular ejection fraction (LVEF), left atrial diameter (LAD) and left ventricular end diastolic diameter (LVEDD) were measured by echocardiogram. Pulmonary artery pressure was measured by the largest law tricuspid regurgitation. Statistic analysis was made to explore the variance of data and the relationship between them by SPSS 17.0 Statistic Software.Results 1. The levels of serum BNP, ET-1 and PAP were much higher in CHF patients than that in the control groups.2. The levels of serum BNP, ET-1 and PAP in different degree of cardiac function according to NYHA class were significant statistic differences to each other class, and arise with the NYHA class.3. The level of serum BNP in the CHF patients showed a significant negative correlation with LVEF (r=-0.628,p<0.001), and a significant positive correlation with LAD (r=0.346,p<0.001), and a significant positive correlation with LVEDD (r=0.541, p<0.001).4. The level of serum ET-1 in the CHF patients showed a significant positive correlation with PAP (r=0.775,p<0.01), a significant negative correlation with LVEF (r=-0.619, p<0.001) and a significant positive correlation with LAD (r=0.337, p <0.001). The level of plasma BNP in the CHF patients showed a significant negative correlation with conrrelation with LVEDD (r=0.549,p<0.001).5. The level of serum BNP in the CHF patients showed a significant positive correlation with ET-1 (r=0.721,p<0.001).6. In binomial logistic regression analysis, ET-1 level was the independent and sensitive index for diagnosing PAP.Conclusions 1. The levels of serum BNP, ET-1 and PAP were significantly higher in chronic heart failure patients, and arise with the NYHA class.2. Logistic regression analysis indicated that ET-1 could be a sensitive and independent index in the diagnosis of PAP.3. The levels of serum BNP, ET-1 and PAP were correlate with the severity of CHF, so measure the levels of plasma BNP, ET-1 and PAP are vety important to CHF patients diagnose, treatment and prognosis evaluation.