To Study The Relation Of B-type Natriureitc Peptide And Ventricular Dysfunction

Objective: The purpose of our research is to understand the regularity of the variation of the plasma BNP in the patients of left ventricular diastolic dysfunction and failure, therefore,we can explore the pathophysiology of left ventricular diastolic dysfunction and search for an evidence to diagnose them earlierly.Methods: 1.The control groupFrom December 2002 to July 2003,20 persons who had been proved to be healthy through health examination in the third hospital of Hebei medical university were selected as a control group(11 men,9 women, average 57±15 years).2. Left ventricular diastolic dysfunction group(LVDD)The selected criteria are①There are basic diseases lead to left ventricular diastolic dysfunction,such as essential hyper- tension,coronary heart disease or hypertrophic cardiomyopathy②There are some abnormal parameters of diastolic function in the echocardiography,while systolic parameters is normal.51 patients were selected( 27 men,24 women,average 62±11 years,34 essential hypertension,12 essential hypertension combined with coronary heart disease,4 coronary heart disease,1 hypertrophic cardiomyopathy)as a group of LVDD. 3. Diastolic heart failure groupThe patients correspond to the diagnostic criteria of the left ventricular diastolic heart failure,which was passed by the National sixth heart failure conference(2001 year,Wuxi) (8 men,6 women,average 65±10 years,4 essential hypertension,9 essential hypertension combined with coronary heart disease, 1 hypertrophic cardiomyopathy).All patients were hospitalized the third hospital of Hebei medical university. All patients had been excluded secondary hypertension﹑valvular heart disease,renal failure,hepatic cirrhosis,thyroid disease,excessive circulating glucocorticoid and chronic pulmonary disease et al.The plasma BNP was determined by solid-phase immunoradiometric assay.BNP reagent box was produced by CIS company in France and was bought from Tianjin XinSiFang company.M-mode,two-dimensional, and pulsed wave Doppler echocardiographic examinations were performed by only one person. HP5500 echocardiography(made in USA) equipped with 2.5MHz was used.Arterial dimension,left atrial dimension,left ventricular chamber dimension,left ventricular septal and posterior wall thickness,left ventricular ejetion fraction,peak early transmitral filling velocity(E wave),peak atrial filling velocity(A wave),ratio of peak early and atrial filling velocity(E/A) were measured.Furthermore, tissue Doppler imaging technique was used to measure the diastolic function of myocardial segments.In the apical four-chamber view, peak velocity of the early diastolic wave(Em) and peak velocity of the late diastolic wave(Am) of the septal and lateral myocardial segment were measured at the mitral annulus.In the apical two-chamber view, peak velocity of the early diastolic wave(Em) and peak velocity of the late diastolic wave(Am) of the anterior and inferior myocardial segment were measured at the mitral annulus.Em/Am was calculated respectively.All data were inputted into computer and statistically analyse with Software pakage of SPSS Ver 11.0.A value of p<0.05 was considered statistically significanct.Result: 1.Compared with the control group,the plasma BNP of LVDD group was increased(27.01±32.97pg/ml versus 13.33±15.93pg/ml) (p<0.05);the plasma BNP of the diastolic heart failure group was increased too(98.61±109.69pg/ml versus 13.33±15.93pg/ml)(p<0.001);furthermore the plasma BNP of diastolic heart failure group was higher than LVDD group(p<0.001).2.The plasma BNP of left ventricular dysfunction group was positive correlation with age(r=0.32,p=0.02),pulse pressure(r=0.32,p<0.01),was negative correlation with diastolic blood pressure(r=-0.28,p<0.05).3.The plasma BNP of diastolic heart failure group was negative correlation with Em间(r=-0.84,p<0.001),Em/Am间(r=-0.70,p<0.01),Em前(r=-0.60,p<0.05),Em前(r=-0.61,p=0.02), Em下(r=-0.63,p<0.05),Am下(r=-0.59,p<0.05) and Em/Am下(r=-0.53,p=0.05).Conclusion:1.It can stimulate BNP s...