Relation Between BNP,NT-proBNP,CysC And Heart Failure With Preserved Ejection Faction

Objectives: To study the correlation between serum natriuretic peptide(BNP),amino terminal natriuretic peptide precursor(NT-pro BNP),cystatin C(Cys C)and ejection fraction retention in heart failure(HFp EF),and to identify the risk factors of HFp EF.Methods: Random selection of 120 cases of HFp EF patients hospitalized in cardiology Department of Yanan University of Affiliated Cardiovascular College Hospital from January 2018 to November 2018,and 144 cases of health control group were examined in the physical examination center of Yanan University Affiliated Hospital during the same Period.Basic data of the subjects included age,gender,body mass index(BMI),blood pressure(systolic and diastolic blood pressure),history(history of hypertension,diabetes and coronary heart disease),cardiac function classification(case group),blood lipid(TC,TG,LDL-C and HDL-C),BNP,NT-pro BNP,Cys C concentration.NYHA grading was used for cardiac function grading.Echocardiographic indexes of all subjects were recorded: LVEF,LVEDD,LAD,IVST,LVPWT,E/A,E/ e '.The biochemical and ultrasonographic indexes of HFp EF group and control group were compared.The changes of BNP,NT-pro BNP and Cys C in different heart function grades of HFp EF,the correlation between BNP,NT-pro BNP,Cys C and echocardiographic indexes were analyzed.At the same time,the risk factors for HFp EF.Patients were identifited.Statistical software SPSS20.0 was used to analyze the data,with P < 0.05 as the statistical significance.Results: 1.Comparison of general clinical data between HFp EF group and control group:Age,BMI,systolic blood pressure and LDL-C in HFp EF group were higher than those in control group,and there was significant difference between the two groups(P < 0.05).TC,TG and HDL-C in HFp EF group were lower than those in control group,and the difference was statistically significant(P < 0.05).There was no significant difference in diastolic blood pressure and sex between HFp EF group and control group(P > 0.05).2.Comparison of serum BNP,NT-pro BNP and Cys C levels between HFp EF group and control group The serum levels of BNP,NT-pro BNP and Cys C in HFp EF group were higher than those in control group,with statistical significance(P < 0.01).3.Comparison of serum BNP,NT-pro BNP and Cys C levels in patients with different NYHA grades in HFp EF group There were statistically significant differences between different NYHA grades in HFp EF group(P < 0.01),The higher NYHA grading was,the higher plasma BNP,NT-pro BNP and Cys C levels were.4.Comparison of routine ultrasound parameters between HFp EF patients and control group LAD,LVEDd,IVST,LVPWT and the ratio of E/ e ' in the HFp EF group was higher than that in the control group,and the difference was statistically significant(P < 0.01).There was no significant difference in the ratio of E/A and LVEF between HFp EF group and control group(P > 0.05).5.Comparison of ultrasound indexes among patients with different NYHA grades in HFp EF group LAD and E/e' increased with the increase of NYHA classification in patients with HFp EF.E/A of NYHA grade IV group was significantly higher than that of the other three groups.The LVEF of NYHA grade IV group was significantly lower than that of the other three groups.IVST and LVPWT in NYHA grade III and IV groups were significantly higher than those in the other two groups.LVPWT in NYHA class II group was significantly higher than that in NYHA class I group(P < 0.05).There was no significant difference in LVEDd among groups with different NYHA grades(P > 0.05).6.To compare the correlation of serum BNP,NT-pro BNP and Cys C levels with ultrasound indices in HFp EF group The correlation of serum BNP,NT-pro BNP and Cys C with LAD,LVEDd,IVST,LVPWT,LVEF,E/A,E/e'in HFp EF group was found.BNP,NT-pro BNP,Cys C were positively correlated with LAD,LVEDd,IVST,LVPWT,E/A,E/e'.Serum BNP,NT-pro BNP and Cys C were positively correlated with LAD,LVEDd,LVPWT,IVST,E/A and E/e'.Three markers were closely correlated with LVPWT,IVST and E/e'(r absolute value < 0.5).Serum BNP,NT-pro BNP and Cys C levels were negatively correlated with LVEF,but the correlation was not obvious.7.Logistic regression analysis of HFp EF patients risk factors Logistic regression analysis showed that age and BMI were independent risk factors for HFp EF(P < 0.05).Conclusions: 1.HFp EF patients are mostly elderly and their independent risk factors are older age and obesity.2.Serum BNP,NT-pro BNP and Cys C levels in HFp EF patients were higher than those in healthy people.3.Serum BNP,NT-pro BNP and Cys C in HFp EF patients were positively correlated with the severity of heart failure in HFp EF patients.4.Serum BNP,NT-pro BNP and Cys C in patients with HFp EF were significantly correlated with ultrasound.