The Analysis Of Influencing Factors Of Adverse Cardiovascular Events And Elevated Level Of B-Type Natriuretic Peptide And High-Sensitivity Cardiac Troponin Ⅰ In Patients With Hypertrophic Cardiomyopathy

Objective:Hypertrophic cardiomyopathy(HCM)is a common genetic cardiovascular disease with clinical heterogeneity.B-type Natriuretic Peptide(BNP)is mainly origined from ventriculars and is one of the usual tools which are used for evaluating cardiac function.The damaged myocardium generates high-sensitivity cardiac troponin I(hs-cTnI),which reflects the degree of damaging in myocardium for high specificity and sensitivity.By now,either the combination of BNP and hs-cTnI or one of the substances is usually used for assessing prognosis of patients with cardiovascular disease.We have found that there is evaluated level of BNP and hs-cTnI in portions of patients with hypertrophic cardiomyopathy.However,the role of aforementioned biomakers in assessing clinical features and prognosis of patients with HCM is controversial.The objective of this research is to analyze the relationship between the two biomakers and prognosis and clinical features of selected HCM inpatients’ in our hospital.Methods:Retrospectively analyzed clinical material of 48 HCM inpatients’ in The First Affiliated Hospital of Dalian Medical University from March 2001 to January 2016.Elevated level of BNP was defined as BNP>100pg/ml,and elevated level of hs-cTnI was defined as hs-cTnI>0.1ug/L(0.040ug/L was 99%fractile).Firstly,patients were divided into adverse-cardiovascular-event group and non-adverse-cardiovascular-event group according to the occurrence of adverse cardiovascular events.Compare the clinical materials.Secondly,patients were divided into both elevated level of BNP and hs-cTnI group and both normal level of BNP and hs-cTnI group.Comparison of clinical data between the two groups was made.All data were analyzed by SPSS17.0 software.Student t test was used to study Measurement data.Chi-square test and Fisher Exact Test were used to study enumeration data.Statistical significance were regarded when P<0.05.Results:1.On the comparison of age of confirmed diagnosis,HCM patients’ with adverse cardiovascular events were older than those without adverse cardiovascular events(t=2.20,P=0.033).2.Female gender was more predominant in HCM patients with adverse cardiovascular events than that in HCM patients without adverse cardiovascular events(χ2=7.24,P=0.007).3.More incidence rate of atrial fibrillation in HCM patients with adverse cardiovascular events than that in HCM patients without adverse cardiovascular events(χ2=4.55,P=0.033).4.Compared with HCM patients without adverse cardiovascular events,more HCM patients with adverse cardiovascular events were examineed both elevated level of BNP and hs-cTnI(χ2=9.52,P=0.002).And both elevated level of BNP and hs-cTnI remained significant after analysis of factors which had impact on the prognosis of HCM patients’ by using Binary Logistic Regression Analysis(P=0.026).5.More incidence rate of atrial fibrillation was found in HCM patients with both elevated level of BNP and hs-cTnI than that in HCM patients with both normal level of BNP and hs-cTnI(χ2=7.28,P=0.007).6.On the comparison of severe ventricular hypertrophy,more severe ventricular hypertrophy of HCM patients’ with both elevated level of BNP and hs-cTnI than that of HCM patients’ with both normal level of BNP and hs-cTnI(t=6.33,P<0.01).7.Severe ventricular hypertrophy and atrial fibrillation were still significant after analyzing the factors that have effect on level of BNP and hs-cTnI in HCM patients by using Binary Logistic Regression Analysis,the respective value was P=0.001 and P=0.009.8.In the aspect of drug treatment,more HCM patients with both elevated level of BNP and hs-c TnI than HCM patients with both normal level of BNP and hs-cTnI had history of taking in amiodarone or propafenone.Conclusion:1.The older age of confirmed diagnosis,female gender,atrial fibrillation and Atrial fibrillation and both elevated level of BNP and hs-cTnI were of predictive value for the occurrence of adverse cardiovascular events in HCM patients.Both elevated level of BNP and hs-cTnI were independent risk factor for adverse cardiovascular events in HCM patients.2.Atrial fibrillation and severe ventricular hypertrophy had effect on level of BNP and hs-cTnI in HCM patients.And both of them were independent risk factors for level of BNP and hs-cTnI in HCM patients.3.More HCM patients with both elevated level of BNP and hs-cTnI than HCM patients with both normal level of BNP and hs-cTnI took in antiarrhythmia agent,such as amiodarone or propafenone.