Diagnostic value of BNP and NT-proBNP for chronic obstructive pulmonary disease complicated with heart failure in the elderly
10.3969/j.issn.1009-0126.2024.09.009
- VernacularTitle:B型钠尿肽和N末端B型钠尿肽前体对老年慢性阻塞性肺疾病合并心力衰竭的诊断价值
- Author:
Meng YIN
1
;
Zijin LI
Author Information
1. 430022 武汉市第一医院呼吸与危重症医学科
- Keywords:
pulmonary disease,chronic obstructive;
heart failure;
natriuretic peptide,lipoprotein(a);
diagnosis;
amino-terminal B type brain natriuretic peptide precursor
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2024;26(9):1020-1025
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore and analyze the relationship between the peripheral blood changes in BNP and NT-proBNP levels and the complication of chronic obstructive pulmonary disease(COPD)and heart failure(CHF)in the elderly.Methods A total of 210 elderly COPD patients admitted to our hospital from April 2021 to August 2023 were enrolled,and according to compli-cation with HF or not,they were divided into COPD+HF group(61 cases)and COPD group(149 cases).Immunofluorescence assay was used to detect the expression levels of BNP and NT-proBNP in the peripheral blood samples of all patients.Routine echocardiography was applied to detect left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),and left ventricular end-diastolic diameter(LVEDD).Pearson correlation analysis was used to evaluate the correlation between peripheral blood BNP and NT-proBNP expression and cardiac function.Multi-variate regression analysis was conducted to analyze the independent influencing factors of COPD complicated with HF,and ROC curves were drawn to evaluate the predictive value of peripheral blood BNP and NT-proBNP levels for COPD complicated by HF.Results The BNP,NT-proBNP,LVESD and LVEDD were significantly higher and the LVEF was obviously lower in COPD+HF group than the COPD group(P＜0.01).BNP,NT-proBNP,LVEF,and LVEDD were risk factors for COPD complicated with HF(P＜0.05,P＜0.01).The sensitivity,specificity,and AUC value of BNP in predicting the complication were 82.0％,94.6％,and 0.802(95％CI:0.712-0.892),and those of NT-proBNP in the prediction were 88.5％,92.6％,and 0.823(95％CI:0.767-0.879),respectively.In the COPD patients complicated with HF,the NT-proBNP and BNP levels in the peripheral blood were negatively correlated with LVEF(r=-0.413,P=0.013;r=-0.521,P=0.000),and positively with LVESD(r=0.356,P=0.010;r=0.565,P=0.000),LVEDD(r=0.335,P=0.014;r=0.501,P=0.000)and NYHA cardiac function grades(r=0.687,P=0.000;r=0.752,P=0.000).Conclusion The high levels of BNP and NT-proBNP in peripheral blood are closely associated with COPD complication with HF,and are related to cardi-ac function grade,which is of great value for the evaluation of HF severity in COPD patients.
