| ObjectiveTo investigate the relationships of plasma N-Terminal Pro-Brain Natriuretic peptide (NT-proBNP) levels and types of heart failure, classifications of heart function in patients with heart failure。MethodsAccording to the clinical manifestations and echocardiographic findings, 136 patients with heart failure were divided into three groups. GroupⅠincludes patients with entire heart failure, GroupⅡwith left heart failure, GroupⅢwith right heart failure. According to the NYHA heart function graduation standard, each group was divided into two subgroups:NAHY classⅢandⅣgroups.38 patients with non-cardiac disease were selected as the control group. Eachocardiogram was performed within 48h after admission and plasma NT—proBNP concertration was detected within 24h after admission in all patients and control subjects. Plasma NT—proBNP levels was compared in patients with different types of heart failure and different NYHA heart function class. The relation between left ventricular ejection fraction (LVEF) and plasma NT-proBNP levels was also analysed.Results1. Plasma NT-proBNP level in patients with heart failure was 372.51±227.830pg/ml; plasma NT-proBNP level in control group was 50.42±35.757 pg/ml, there was significant difference between two groups(P< 0.05).2.Plasma NT-proBNP level in patients with entire heart failure and NAHY classⅢ(ⅠA) subgroup was 399.54±194.259pg/ml; in patients with entire heart failure and NAHY classⅣ(ⅠB) subgroup was 675.64±318.352pg/ml, plasma NT-proBNP level in I B subgroup was higher than that in I A subgroup (P< 0.05).3.Plasma NT-proBNP level in patients with left heart failure and NAHY classⅢ(ⅡA) subgroup was 397.19±208.171pg/ml; in patients with left heart failure and NAHY classⅣ(ⅡB) subgroup was 1142.73±494.571pg/ml, plasma NT-proBNP level inⅡB subgroup was higher than that inⅡA subgroup (P<0.0 5).4. Plasma NT-proBNP level in patients with right heart failure and NAHY classⅢ(ⅢA) subgroup was 70.35±38.897pg/ml; in patients with right heart failure and NAHY classⅣ(ⅢB) subgroup was 103.08±80.274pg/ml, there was no significant difference of plasma NT-proBNP levels between two subgroups (P>0.05).5. Plasma NT-proBNP level in patients with entire heart failure and NAHY classⅢ(ⅠA) subgroup was 399.54±194.259pg/ml; in patients with left heart failure and NAHY classⅢ(ⅡA) subgroup was 397.19±208.171 pg/mlpg/ ml, in patients with right heart failure and NAHY classⅢ(ⅢA) subgroup was 70.35±38.897pg/ml. Plasma NT-proBNP level inⅠA subgroup andⅡA subgr-oup were higher than thatⅢA subgroup (P<0.05), but there was no significant difference betweenⅠA subgroup andⅡA subgroup (P>0.05).6. Plasma NT-proBNP level in patients with entire heart failure and NAHY classⅣ(ⅠB) subgroup was 675.64±318.352pg/ml; in patients with left heart failure and NAHY classⅣ(ⅡB) subgroup was 1142.73±494.571pg/ml; in patients with right heart failure and NAHY classⅣ(ⅢB) subgroup was 103.08±80.274pg/ml. Plasma NT-proBNP level inⅠB subgroup andⅡB subgroup were higher than thatⅢB subgroup (P<0.05), but there was no significant difference betweenⅠB subgroup andⅡB subgroup (P>0.05).7. The left ventricular ejection fraction(LVEF) in patients with entire heart failure was 39%, blood plasma NT-proBNP levels was 372.51±227.830pg/ml; LVEF in patients with left heart failure was37%, blood plasma NT-proBNP levels was 842.73±354.571pg/ml; LVEF in patients with right heart failure was 60%, blood plasma NT-proBNP levels was 93.08±60.274pg/ml; There was negative correlation between LVEF and plasma NT-proBNP levels in patients with entire heart failure (r=-0.465, p=0.02); There was negative correlation between LVEF and plasma NT-proBNP levels in patients with lefte heart failure (r=-0.725, p=0.001); but there was no correlation between LVEF and plasma NT-proBNP levels in patients with right heart failure (r=-0.126, p=0.398)ConclusionsPlasma NT-proBNP levels was increased in patients with heart failure, and there were relationships between plasma NT-proBNP levels with heart failure types and NYHA heart function classifications.Plasma NT-proBNP levels in patients with entire heart failure and left heart failure were higher than that in patients with right heart failure; but there was no significant difference in patients with entire heart failure and left heart failure; Plasma NT-proBNP levels in patients with right heart failure was not higher than that in control group. Plasma NT-proBNP levels were correlated with LVEF in patients with entire heart failure or left heart failure negatively, but there was no correlation of plasma NT-proBNP level and LVEF in patients with right heart failure.Therefore, plasma NT-proBNP is a valuable parameter in the diagnosis of entire heart failure or left heart failure, but the diagnostic value of NT-proBNP in right heart failure is limited. |
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