Left Atrial Function Changes Of Heart Failure Patients With NT-proBNP Slightly Elevating And Preserved Ejection Fraction

Objective:The study aims to explore the left atrial function of HFPEF patients with NT-proBNP slightly elevating,by analysing the left atrial function-related echocardiographic parameters of patients(50-80 years old)with heart failure ejection fraction preserving(HFPEF)when whose NT-proBNP was slightly elevated(300-1800pg/ml).Methods:61 patients(whose diagnosis was based on 2016 European Guidelines for the Treatment of Acute and Chronic Heart Failure)with suspected HFPEF(50-80 years old,sinus rhythm,NT-proBNP index was in the range of 300-1800pg/ml)being admitted to the Department of Cardiology,the First Affiliated Hospital of Soochow University from August 2016 to January 2019 were analyzed retrospectively,in addition to selecting 62 patients whom was at the same stage,age but no diagnosis of heart failure for the control group.Examination of echocardiography and plasma N-terminal pro-brain natriuretic peptide(NT-proBNP)were performed in all selected subjects,and statistical analysis was performed on every parameter index of the left atrial function in two groups,echocardiography;additionally,differences and correlations between various evaluation parameter indexes of the echocardiography mentioned above and NT-proBNP were discussed to further understand changes of the left atrial function in patients with mildly elevated HFPEF.Results:The analysis indicated that:1.Comparison of LAD,LAVI,E peak,A peak,A',E/E',LAFF,regurgitation,mitral and tricuspid regurgitation,PAS between control group and heart failure group had statistically significant differences(P<0.05),and all of LAD,LAVI,E peak,A peak,E/E',mitral and tricuspid regurgitation,LAFF,PAS value of heart failure group were higher than that of control group,but whose A' value was lower than the control group;2.Comparison of LVIDd,LVIDs,LVEF,IVS and LVPWd between control group and heart failure group did not have statistically significant difference(P>0.05);3.Correlation between NT-proBNP and LAD,LAVI of heart failure group had statistically significant differences(P<0.05),the associated direction was positive,and the correlation coefficients were 0.764 and 0.674 respectively;4.Correlation between NT-proBNP and E peak,A peak,A',E/E',PAS,LAFF did not have not have statistically significant difference(P>0.05).Conclusions:1.NT-proBNP index increase of HFPEF patients:LAD,LAVI,E peak,A peak,E/E',mitral and tricuspid regurgitation,LAFF,PAS were higher,whose A' value?E/Awas lower.2.Left atrial pathological changes have already occurred in HFPEF patients when the NT-proBNP index is slightly elevated,which is characterized by the left atrial enlargement,the left atrial hypertension and compensatory enhancement of the left atrial systolic function.3.NT-proBNP index increase of HFPEF patients had positive correlation with the left atrial diameter and left atrial volume index.4 It is feasible to evaluate patients with HFPEF by NT-proBNP index and the left atrial structure changes of echocardiography.