The Study Of The Correlation Between Plasma Brain Natriuretic Peptide Levels And Left Ventricular Hypertrophy And Diastolic Function In Hypertension

Objective:To analysis the relationship between plasma brain natriuretic peptide (BNP) level and left ventricular hypertrophy, the author observeded the changes of left ventricular hypertrophy(LVH) and left ventricular diastolic dysfunction with ACEI-based comprehensive antihypertensive treatment in hypertensive patients, and accessed the value of plasma BNP levels to predict the reversal of LVH and changes of left ventricular diastolic function.Methods:80hypertension patients (mean age55.2±10.4years) were divided into LVH group (35cases) and non-LVH group (45cases). in addition,30healthy subjects (mean age53.4±9.7years) served as normal control group. Hypertensive patients was treated with ACEI-based comprehensive antihypertensive drugs for no less than30weeks. Electrocardiography was performed to detect the left ventricular mass index (LVMI) and E/A ratio, Plasma BNP was measured by Enzyme-linked immunosorbent assay (ELISA). The relationship between plasma BNP level and LVMI and E/A ratio was analyzed.Results:Plasma BNP level (201.2±52.0vs91.4±22.6,37.2±14.3ng/L, P <0.01)was significantly higher in LVH group than non-LVH group and normal control group. After ACEI-based comprehensive antihypertensive treatment, LVMI (142.7±21.5vs116.4±11.2g/m2, P<0.01), BNP level (201.2±52.0vs65.3±22.4ng/L, P<0.01) decreased and E/A ratio (0.6±0.3vs1.0±0.4, P <0.01)increased in LVH group obviously, but LVMI (116.4±12.3vs110.9±12.5g/m2, P>0.05), BNP(91.4±22.6vs76.1±21.6ng/L, P>0.05) and E/A ratio(1.1± 0.4vs1.1±0.1, P>0.05) didn’t significantly change in the non-LVH group Significantly positive correlation between BNP level and LVMI(r=0.4, P<0.01) and significantly negative correlation between BNP level and E/A ratio (r=-0.6, P <0.01) were established.Conclusions:1. Plasma BNP levels could reflect LVH and left ventricular diastolic function status in hypertension patients.2. BNP levels were higher in hypertension patients with LVH, especially LVH with diastolic dysfunction, than others. BNP may be a sensitive indicator for LVHl,especially LVH with diastolic dysfunction.3. ACEI-based comprehensive antihypertensive treatment decreased LVMI, BNP levels and increased E/A ratio in LVH group, but did not affect hypertension with non-LVH.4.ACEI-based comprehensive antihypertensive therapy could not only partially reverse LVH and improve diastolic function, but also decrease BNP level. BNP perhaps is a sensitive indicator of the effective control of blood pressure and the reversal of LVH and left ventricular diastolic dysfunction.