The Cardic Function Groupings Of Type2Diabetes Mellitus With Acute Myocardial Infarction Patients And Its Correlation With Plasma NT-probnp Concentration

Objective To investigate the onset of cardiac function of type2diabetesmellitus patients suffering acute myocardial infarction which assessed byechocardiograph and clinical Killip classification, and to explore the relationshipbetween the different groupings of cardiac function and the concentration ofN-terminal pro-brain natriuretic peptide (NT-proBNP).Method From August2012to December2013,156cases type2diabetesmellitus with acute myocardial infarction (including STEMI and NSTEMI)patients hospitalized in The First Affiliated Hospital of GuangXi MedicalUniversity, whose clinical data was Retrospective analyzed.The cardiac function was assessed by echocardiograph (LVEF value andE/A value) and clinical Killip classification respectively. What more, therelationship between the different groupings of cardiac function and theconcentration of NT-proBNP was to explore. Finally, we used the correlationanalysis to test the correlation between plasma NT-proBNP concentration andKillip classifications, heart LVEF value and E/A value.Results (1)Grouping the cardiac function by echocardiograph(LVEF values and E/A value),we find out that in the total number of type2diabetes with acutemyocardial infarction patients,25%cases had normal left ventricular systolic anddiastolic function.5.8%cases had isolated systolic dysfunction.49.2%cases hadisolated diastolic dysfunction, while the presence of both systolic and diastolicdysfunction cases were accounted for20%.Through statistical analysis, theplasma concentration of NT-proBNP of above-mentioned four cardiac functiongroupings was statistically significant differences (F=5.793, P <0.01).①Theplasma NT-proBNP concentration was highest in simultaneously presenting ofleft ventricular systolic and diastolic dysfunction grouping, followed by isolatedsystolic dysfunction grouping, which were both higher than the normal heartfunction grouping, and the difference was statistically significant.②TheNT-proBNP concentration of isolated diastolic dysfunction grouping was higherthan the normal heart function grouping, but the difference was not statisticallysignificant.③The NT-proBNP plasma concentration of normal cardiac functiongrouping according to Echocardiograph has far exceeded the negative predictiveconcentration (400pg/ml) range.(2) Assessing the on admission cardiac function by clinical Killipclassifications in type2diabetes mellitus with AMI patients, we find out thatKillip I, II, III, IV class are accounted for49.1%、27.5%、11.7%、11.7%respectively. Furthermore, comparing the four groups’ plasma NT-proBNPconcentration, the difference was statistically significant (F=9.303, P <0.001).①The NT-proBNP concentration from Killip I to IV grades level are graduallyincreased.②Killip IV grade’s NT-proBNP concentration is much higher than therest of the group.③The NT-proBNP plasma concentration of Killip I gradehas far exceeded the negative predictive concentration range.(3)Correlation analysis showed that the correlation between NT-proBNP concentration and clinical Killip classes was positive (r=0.421, P=0.000),while with cardiac LVEF value and E/A was negative (r=-0.349, P=0.000; r=-0.266, P=0.003).Conclusion Type2diabetes mellitus with AMI patients are oftenaccompanied by cardiac failure and the isolated diastolic dysfunction takes thehighest proportion of all of these patients. Plasma NT-proBNP concentration hasa good correlation to clinical Killip classifications and echocardiograph (LVEFvalues and E/A value) in the assessment of cardiac function and plasmaNT-proBNP concentration is much more sensitive of early cardiac dysfunctioncompared with the other two methods.