The Correlational Research Between BNP And The Internal Diameter Of Left Atrium In Hypertension Patients

Objective: Hypertension is an very important risk factor incardiovascular and cerebrovascular diseases. Hypertension is one of the mostcommon cardiovascular disease and is also the risk factor that leading cause ofdeath the human common diseases such as stroke, coronary heart disease,heart failure. Hypertension is mainly involving the organs for heart, in theearly stage presents with left ventricular hypertrophy and then secondary leftventricular diastolic function[1，2].Left atrial enlargement is one of the earlyperformances of target organ damage to the heart in hypertension.Enkephalin which is also called B-type Natriuretic Peptide(BNP) is akind of polypeptides neurohormone from pig brain by Japanesehakeems Sudoh, et al[3]. Brain natriuretic peptide(BNP) is a myocardialhormone mainly secreted by myocardial cells It is synthesized and secreted bymyocardial cells reactively when the blood volume increase sharply inducingthe change of ventricular wall’s tension and over loading of heart ventricle’spressure. It plays the role of natriuretic, diuresis, relaxation of vascular,antagonism to renin-antagonism-aldosterone system(RAAS), inhibiting theactivity of sympathetic nervous system(SNS), et al.BNP can also be used forthe diagnosis of disease of cardiovascular system, the evaluation of cardiacfunction, the authentication between cardiac dyspnea and noncardiac dyspneaand as an important reflection effectiveness of heart failure.It has been confirmed that the level of BNP in blood plasma would raisein the process of myocardial hypertrophy. Therefore, the content of BNP canbe used as an index for the degree of myocardial cell hypertrophy. Thoseabove all suggest that the level of BNP can be used for the diagnosis of heartfailure, the evaluation of cardiac function, the authentication between cardiac dyspnea and noncardiac dyspnea and as an important reflection effectivenessof heart failure, and recently some scholars use the level of BNP to reflectmyocardial hypertrophy, but left atrial enlargement is one of the earlyperformances of target organ damage to the heart hypertension. Themechanism that hypertension caused left atrium enlargement have beenreported in1986[5].Due to long-term sustained systemic arterial pressureincreasing, hypertension caused the afterload of the heart increases, resultingin residual blood flow of left ventricular end systolic and diastolic heartvolume increase, leading to compensatory hypertrophy of left heart,compliance, thereby reducing the capacity and pressure increase, leading toincreased left ventricular end-diastolic pressure and left ventricular pumpingfunction abate, after mitral valve into the left ventricular blood flow reduction,increase in the number of residual blood left the room, in order to maintain thestability of the pressure difference between atrioventricular and essential ofcardiac output, compensatory excessive contraction of left atrium, left atrialincrease of power, and gradually expand the left atrium. High blood pressure,therefore, first affects left ventricular structure and left ventricular myocardialhypertrophy of left atrial remodeling, after causing the left atrial enlargement.This research is to investigate the correlational research of BNP and theinternal diameter of left atrium in hypertension patients! by echocardiography,to evaluate the relationship between the level of BNP and early hypertensiontarget organ damage, to find early hypertension target organs heart damagebefore myocardial hypertrophy, in order to provide basis to prevent thedamage, to reduce the morbidity and mortality in cardiovascular disease, toguide the treatment of the early target organ damage in hypertension patients.Methods: Subjects were chosen from Cardiology Department Clinic ofHebei Medical University Second Hospital. The entry criterion of our studywas the criterion for the diagnosis of hypertension in2010of《The preventionand control of hypertension guidelines of China》.The entry criterion areprimary hypertension patients without any antihypertensive treatment orprimary hypertension patients that did not take any medicine in5half-life periods. All subjects were strictly in accordance with the entry and exclusioncriterion. Their treatment time was from December1st to September1st2012.Total number of subjects were80, among them female were50, malewere30. We recorded their general condition(gender, age, height, weight, etc),blood pressure level(systolic pressure, diastolic pressure), the level of BNP,the internal diameter of left atrium, blood lipid, fasting blood sugar, highblood pressure course,etc. Combining with domestic and foreign literatures[4]all the data of the internal diameter index of left atrium are divided into twogroups, high LADI group, normal LADI group.Statistical methods: The clinical and biochemical data of subjects arepresented as mean±standard deviation. All the data of the internal diameterindex of left atrium are divided into two groups, the clinical and biochemicaldata for subjects between two groups were compared through t test, to analysisthe relationship between the clinical data and left atrial diameter index throughmultiple linear regression analyses. P<0.05as a statistically significantdifference. In our study, SPSS16.0program was used to conduct statisticalanalyses.Results: Date of high LADI group: including29patients, age56.69±11.97, height161.34±6.14, hypertension course9.07±1.75, the levelof SBP147.79±13.82, the level of DBP86.45±11.77, the level of BNP37.36±14.19, FBG5.16±1.01, TG1.94±1.90, CHOL5.05±0.94, and the dataof normal LADI group: including51patients, age53.41±8.63, height164.17±6.63, hypertension course7.90±0.88, the level of SBP144.10±14.41,the level of DBP84.08±11.43, the level of BNP28.85±14.31, FBG5.27±0.71,TG1.72±1.12, CHOL4.65±0.84. Among above data, age, height,hypertension course, the level of BNP, FBG, TG, CHOL, SBP, DBP were nosignificant difference between high LADI group and normal LADIgroup(P>0.05).However, date of high LADI group were larger than the date ofnormal LADI group on the level of BNP, SBP and DBP(P<0.05).The multiplelinear regression analysis which reflected correlation between clinical data andLADI indicated that the influencing factors with liner regression were the level of BNP, SBP, DBP.Statistical results show that: the standardizedregression coefficient in the order of descending were the level of BNP:0.476(P=0.000), SBP：0.331(P=0.042), DBP：0.234(P=0.032).Conclusion:1Among above data, age, height, hypertension course, the level of BNP,FBG, TG, CHOL, SBP, DBP were no significant difference between highLADI group and normal LADI group(P>0.05).However, date of high LADIgroup were lager than the date of normal LADI group on the level of BNP,SBP, DBP(P<0.01), with significant difference.2The multiple linear regression analysis which reflected correlationbetween clinical data and LADI indicated that the influencing factors withliner regression were the level of BNP, SBP, DBP. The level of BNP is themost important factor that can reflect LADI.