Short-term Prognosis Of Change Of Serum N-terminal Pro-b-type Natriuretic Peptide Levels During Admission Period In Patients With Heart Failure

ObjectiveTo investigate the value of NT-proBNP in diagnosis and evaluation of heart failure,and explore the relationship between the changes of NT-proBNP levels after treatment andshort-term prognosis in patients with heart failure.Methods152patients diagnosed with heart failure in admission, and50healthysubjects(control group) were enrolled in this study. LVEF was detected withechocardiography after admission in all subjects. The serum concentration of NT-proBNPwas determined with electrochemiluminescence immunoassay. After medical therapy, allpatients with heart failure were symptomatically improved and discharged, and the levelsof NT-proBNP were detected again before discharge. All patients were followed up for3months, and the cardiovascular events were recorded. According to the cardiovascularevents within3-month follow-up period, patients were divided into event group and noevent group. The levels of NT-proBNP were compared between patients with heart failureand normal controls, and the correlation between NT-proBNP levels with NYHA heartfunction class and LVEF were analysed. The correlation between the changes ofNT-proBNP levels after treatment and the cardiovascular events within3-month follow-upperiod was also analysed.Results1. The serum NT-proBNP levels in heart failure group were1735.2±578.9ng/ml, andin normal controls group were173.8±30.2ng/ml. The concentration of NT-proBNP inpatients with heart failure were significantly higher than that in normal controls （P<0.05）.The levels of NT-proBNP were1278.6±252.2ng/ml in patients with NYHAheart function class Ⅱ(NYHA Class Ⅱ),1685.5±486.1ng/ml in NYHA Class Ⅲ,2296.5±449.7ng/ml in NYHA Class Ⅳ. There were statistical difference of NT-proBNPlevels respectively(P<0.05). The higher stage of NYHA-classification, the higher level ofNT-proBNP, and the NT-proBNP levels were positive correlated with NYHAclassification(r=0.709,P<0.05).2. The levels of NT-proBNP were2323.3±419.5ng/ml in patients with LVEF≤40%,1651.5±249.1ng/ml in patients with LVEF from41%to49%,1210.7±213.0ng/ml inpatients with LVEF≥50%. There were statistical difference respectively(P<0.05). Thehigher value of LVEF, the lower level of the NT-proBNP and the NT-proBNP levels werenegative correlated with LVEF(r=-0.838, P<0.05).3. The levels of NT-proBNP in no event group were1482.3±520.1ng/ml afteradmission, and618.1±303.6ng/ml before discharge. The levels of NT-proBNP in eventgroup were2165.5±581.1ng/ml after admission, and1457.6±521.3ng/ml before discharge.The NT-proBNP levels in all patients with heart failure decreased during admission period,and the difference were statistically significant (P<0.05). The change rate of NT-proBNPlevels in event group were0.3273±0.1359, and in no event group were0.5808±0.1535,there were statistical difference between two groups (P<0.05). The patients whoseNT-proBNP levels were not significantly decreased during admission period had morecardiovascular events, while the patients whose NT-proBNP levels decreased significantlyhad less events.Conclusion1.The levels of NT-proBNP are closely related to the severity of heart failure, thehigher level of the NT-proBNP, the higher stage of the NYHA heart function classification,and the lower value of the LVEF.2.The short-term prognosis in patients with significantly decreased NT-proBNP levelsafter medical treatment in admission were better than that of patients with less decreasedNT-proBNP levels.