Clinical characteristics of severe chronic heart failure patients with normal blood B-type natriuretic peptide
10.3760/cma.j.issn.0253-3758.2010.11.004
- VernacularTitle:慢性重度心力衰竭患者血B型利钠肽浓度正常的临床意义探讨
- Author:
Zhen-Yu YANG
1
;
Ku-Lin LI
;
Qiang WANG
;
Ru-Xing WANG
Author Information
1. 南京医科大学附属无锡市人民医院
- Keywords:
Heart failure,congestive;
Natriuretic peptide,brain;
Prognosis
- From:
Chinese Journal of Cardiology
2010;38(11):979-982
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical features of severe chronic heart failure patients with normal B-type natriuretic peptide (BNP). Methods A total of 57 patients with severe chronic heart failure ( New York Heart Association class Ⅲ and Ⅳ ) were included in this prospective control study from Dec. 2002 to Oct. 2009. Group A included 13 patients with normal BNP ( ＜ 100 ng/L) and group B included 44 patients with increased BNP ( ＞ 100 ng/L). Group A patients were followuped for ( 19. 6 ±14. 7)months and group B patients for (72. 5 ± 17. 1 ) months. Results The baseline clinical characteristics of two groups were comparable. Left ventricular end diastolic diameter (LVEDd) of group A was larger than group B [ (70. 56 ± 4. 33 ) mm vs. ( 63.73 ± 3.75 ) mm, P ＜ 0. 05 ], the left ventricular ejection fraction (LVEF) of group A was lower than group B [ (24. 16 ± 2. 50) % vs. (28.49 ± 2.63 ) %, P ＜ 0. 05 ]. The number of patents tolerating metoprolol in group A is lower than in group B (7/13 vs. 39/44,P ＜0. 05),and the tolerant dose of metoprolol in group A is lower than in group B [ ( 12. 5 ±6. 25)mg/d vs. (24. 20 ±11.22)mg/d,P ＜ 0. 05 ]. The level of BNP in group B were significantly higher at acute stages than at remission stages [(962.73 ± 165.00) ng/L vs. (876.24 ± 167.70) ng/L, P ＜ 0.05], but remained unchanged in group A [ (74. 03 ± 11.18) ng/L vs. ( 71.38 ± 11.68) ng/L, P ＞ 0. 05 ]. The mortality of group A was higher than group B( 11/12 vs. 6/44, P ＜0.05). The binary logistic regression analysis (backward) showed that normal B-type natriuretic peptide was an independent predictor of cardiovascular mortality in patients with severe chronic heart failure ( OR = 45.488, 95% CI = 5. 322 - 388. 791 ).Conclusion Normal BNP in patients with severe chronic heart failure suggests the exhaustion of BNP secretion and associated poor prognosis.
