Influence of acute and chronic myocardial loading conditions, function, structural changes and extracardiac factors on NT-proBNP in asymptomatic patients with preserved ejection fraction

被引：10

作者：

Schulz, Olaf ^{[1
]}

Rudolph, Andre ^{[2
]}

Scheiner, Sarah ^{[1
]}

Mut, Helena ^{[3
]}

Schulz-Menger, Jeanette ^{[2
]}

Berghoefer, Gunnar ^{[1
]}

Bensch, Ricarda ^{[1
]}

Kraemer, Jochen ^{[1
]}

Schimke, Ingolf ^{[3
]}

机构：

[1] Intervent Kardiol Spandau, D-13585 Berlin, Germany

[2] Univ Med Berlin, HELIOS Klinikum Berlin Buch, Working Grp Cardiac MR, Berlin, Germany

[3] Univ Med Berlin, Med Klin Kardiol, Berlin, Germany

来源：

CLINICAL RESEARCH IN CARDIOLOGY | 2011年 / 100卷 / 01期

关键词：

NT-proBNP; Pressure overload; Volume overload; Physical stress test; Dobutamine stress test; NATRIURETIC PEPTIDE LEVELS; LEFT-VENTRICULAR HYPERTROPHY; CHRONIC HEART-FAILURE; DOPPLER-ECHOCARDIOGRAPHY; BNP LEVELS; EXERCISE; CARDIOMYOPATHY; MANAGEMENT; SEVERITY; REGURGITATION;

D O I：

10.1007/s00392-010-0210-2

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

We compared the effect of different loading conditions, parameters of structural heart disease and extracardiac confounders on NT-proBNP to validate the application of NT-proBNP for a characterisation of loading conditions and clinical course of patients with chronic heart diseases. NT-proBNP was measured in 15 controls and 34 patients with preserved ejection fraction and chronic pressure (by aortic stenosis) or volume overload (by aortic or mitral regurgitation) before and after physical as well as dobutamine stress. Myocardial fibrosis was evaluated by contrast-enhanced cardiovascular magnetic resonance. In patients with elevated NT-proBNP due to chronic pressure or volume overloaded ventricles, physical and dobutamine stress were associated with only marginal nonsignificant additional NT-proBNP responses. Univariate analyses showed that myocardial fibrosis has the greatest effect on NT-proBNP (P < 0.01). Forward regression analyses revealed left ventricular filling, systolic function, the presence of valvular heart disease, serum creatinine and responses to dobutamine stress as independent determinants of NT-proBNP (P < 0.05 each). NT-proBNP cannot be used simply to characterise intensity of ventricular load. Character and duration of loading conditions, cardiac structure and function, as well as confounders should be considered when NT-proBNP is used for clinical follow-up assessment.

引用

页码：57 / 65

页数：9

共 34 条

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