The Change Of The Levels Of B-type Natriuretic Peptide And Inflammatory Factors In Patients With Chronic Heart Failure Cardiac Dyssynchronization

ObjectiveHeart failure(HF) has become one of the most common and the worst disease in the world. Though we have made great progress on medication treatment,the incidence and death rates of HF are still high.Cardiac resynchronization therapy(CRT) is a new technology to treat chronic heart failure(CHF).B-type natriuretic peptide(BNP) and inflammatory factor detection is a powerful tool to diagnose CHF.The objective of this study is to explore the correlations of cardiac dyssynchronization(CD),the levels of B-type natriuretic peptide (BNP) and inflammatory factors in patients with congestive heart failure(CHF) by comparing and analyzing the CD and the concentrations of BNP,TNF-a and IL-6.Subjects and methodsA total of 168 outpatients and inpatients with chronic heart failure were divided into two groups according to QRSD:group A(n=64,QRSD-120ms) and group B(n=104, QRSD＜120ms).Each group was divided into two subgroups according to the conditions of cardiac dyssynchronization:subgroup A1(n=48),subgroup A2(n=16),subgroup B1(n-36) and subgroup B2(n=68).Patients' serum BNP and inflammatory factor concentrations were tested and evaluated with different methods.Then the conditions of cardiac dyssynchronization between group A and group B,and the concentrations of BNP and inflammatory factor among the four subgroups were compared.The blood concentrations of BNP were measured in all patients.At last,data was input into the computer by two professional staffs,and data were analyzed with the software SPSS 15.0.Results1.168 patients were classified into two groups according to QRSD,and there was no statistically significant for the fundamental characteristics between QRSD≥120ms group(group A) and QRSD＜120ms group(group B).2.There was significant difference for cardiac dyssynchronization between the patients in group A and group B.However,there was still 34.6%cardiac ventricle dyssynchronization in the group B.Comparing the concentrations of TNF-a,BNP,and IL-6 between group A and group B,the concentration of TNF-a,BNP,and IL-6 in groupA were(144.2±12.06) ng·L^-1,(18.91±8.08) ng·L^-1,and(38.11±16.62) ng·L^-1,respectively.The concentrations of TNF-a,BNP,and IL-6 in groupB were(120.5±8.96) ng·L^-1,(26.14+_<sub>6.50) ng·L^-1, and(24.89±9.97) ng·L^-1,respectively.The concentrations of TNF-a,BNP,and IL-6 in all patients were(129.0±9.59) ng·L^-1,24.76±7.15) ng·L^-1,and(27.99±10.74) ng·L^-1, respectively.The concentrations of the above measurements in group A were significantly higher than those in group B(all P＜0.01).The comparions between group A,group B and all patients group show that the above measurements group A is significantly higher than those in all patients(P＜0.05),however,there was no statistical significance between group B and all patients group.3.In the four subgroups,without consideration of QRSD,the concentrations of TNF-a,BNP, and IL-6 in group A1 were(148.7±12.41) ng·L^-1,(19.30±8.31) ng·L^-1,and(38.93±16.86)ng·L^-1,respectively.The concentrations of TNF-a,BNP,and IL-6 in group A2 were (120.8±10.22) ng·L^-1,(26.61±7.75) ng·L^-1,and(25.12±12.44) ng·L^-1,respectively. The concentrations of TNF-a,BNP,and IL-6 in group B1 were(141.1±11.57) ng·L^-1, (18.74±7.98) ng·L^-1,and(37.70±16.47) ng·L^-1,respectively.The concentrations of TNF-a,BNP,and IL-6 in group B2 were(120.4±8.70) ng·L^-1,(25.91±5.96) ng·L^-1,and (24.78±8.34) ng·L^-1,respectively.The blood concentrations of BNP,TNF-a,and IL-6 in patients with cardiac dyssynchronization were significantly higher than those in the patients with normal ventricle motion(P＜0.05).4.The concentrations of BNP,TNF-a,and IL-6 in those with cardiac dyssynchronization were(144.2±12.06) ng·L^-1,(18.91±8.08) ng·L^-1,and(38.11±16.62) ng·L^-1, respectively.The concentrations of BNP,TNF-a,and IL-6 in the group with normal ventricle motion were(120.5±8.96) ng·L^-1,(26.14±6.50) ng·L^-1,and(24.89±9.97) ng·L^-1,respectively.The blood concentrations of BNP,TNF-a,and IL-6 in patients with cardiac dyssynchronization were significantly higher than those in the patients with normal ventricle motion(P＜0.01),and the blood concentrations of BNP,TNF-a,and IL-6 in patients with cardiac dyssynchronization were significantly higher than those in the all patients group.Conclusions1.The QRSD can not reflect the condition of cardiac dyssynchronization completely for the CHF patients.2.The levels of inflammatory factors such as TNF-a and IL-6 increase in CHF patients with Cardiac Dyssynchronization.3.The blood concentration of BNP in patients with CHF can reflect the condition of cardiac dyssynchronization sensitively,and it may become an effective index to screen and evaluate the effectiveness of treatment of CRT in severe CHF patients.