The Predictive Value Of The Plasma BNP To Recent Ventricular Remodeling In Patients With Acute Myocardial Infarction After Primary Percutaneous Coronary Intervention

Objectives To investigate the relationship between plasma Brain natriuretic peptide(BNP) level and left ventricular wall motion score index(LVWMSI) in patients with acute ST-segment elevation myocardial infarction(STEMI),and the predictive value of the Plasma BNP to recent ventricular remodeling,and the short term prognosis.Methods Sixty four patients with acute ST segment elevation myocardial infarction(STEMI) for the first time that were admitted in the affiliated hospital of Hebei University from Jan.1st 2014 to Jun.30 st 2014,who were treated with primary percutaneous coronary intervention(p-PCI) within 12 h of onset. All patients include 49 male patients and 15 female patients,and the ages from 36 to 73 years(56.00±9.62)years.The BNP levels were measured on admission, 24 hours after chest pain onset and at the 7th day morning after admission.Based on the BNP level on 24 th hour, all patients were divided into three groups :group A(n=10) :BNP≤100pg/m L; group B(n=39):100pg/m L <BNP<400pg/m L; group C(n=15):BNP≥400pg/m L). Left ventricular ejection fraction(LVEF), left ventricular end diastolic volume(LVEDV) and left ventricular wall motion score(LVWMS) were measured,and left ventricular wall motion score index(LVWMSI) were calculated through echocardiography at the 7th day and the 6th month after PCI. The relationship of BNP level of24 hour with LVWMSI was analysed.According to the results of the Echocardiography,the increased rate of the left ventricular end diastolic volume was calculated,△LVEDV%=(the6th month LVEDV-the 7th day LVEDV) /the7 th day LVEDV ×100%. Based on the increased rate of the left ventricular end-diastolic volume in all patients further divided into the ventricular remodeling group( △LVEDV>20%, n=19) and non-remodeling Group(△LVEDV<20%,n=45).To investigate the risk factors of the ventricular remodeling and the predictive value of BNP on ventricular remodeling.Result(1) BNP levels of 24 th hour after onset and left ventricular wall motion score index was positively related(r=0.703,P<0.01);(2) BNP levels at the first 24 h and the 7th day of onset,are risk factors for the recent occurrence of ventricular remodeling;(3) The area under the ROC curve of BNP level of 24 hour onset predicting ventricular remodeling within6 months was 0.825,P<0.05;the boundary Value of 331.5pg/ml,sensitivity of ventricularremodeling prediction was 73.7%,specificity was 84.4%;The area under the ROC curve of BNP level of the 7th onset predicting ventricular remodeling within 6 months was 0.760,P<0.05;the boundary Value of 80.0pg/ml,sensitivity of ventricular remodeling prediction was 52.6%,specificity was 88.9%.Conclusions(1)Plasma BNP level of 24 huor onset provides information about the change of heart function in patients with acute myocardial infarction were treated by p-PCI.(2)the increasing plasma BNP level of 24 hours and the 7th day onset are risk factors for the recent occurrence of ventricular remodeling in patients with acute myocardial infarction were treated by p-PCI, may be strong predictor for recent ventricular remodeling,and the first have more predictive value.Early stage BNP level in patients with acute myocardial infarction were treated by p-PCI provides information about major adverse cardiac events(MACE).