Analysis Of The Effect Of Baseline ANP Levels On The Severity And Prognosis Of Patients With Chronic Heart Failure

Background and Objective: Heart failure is the final stage ofvarious heart diseases, which is one of important causes of death fromheart diseases. The diagnosis of heart failure mainly rely onsymptom(NYHA class)、signs、echocardiography(LVEF),and combineBNP and other markers of heart failure. BNP has been widely used inclinical among these peptide hormones as an indicator of determiningthe severity of patient with heart failure in our country and Europecountries， while ANP is used as the indicator of heart failure in Japan.This paper discusses the correlation the baseline ANP with LVEF、NYHA classification and the impact of baseline BNP level on long-termprognosis of patient with heart failure patient to determine whether ANPcan be an indictor to judge the severity and prognosis of patient withheart failureMaterials and Methods:1. General information: We select70patients with heart failur ofhospitalized grade NYHA II-IV,58cases were male and12females,mean age（61.36±11.48） years, age ranges（29-82years）.2. Relevant inspection:All patients receive the inspection of blood routine, liver function,kidney function, echocardiography, ECG, chestradiograph and related inspection, and testing neural hormone levels,and plasma atrial natriuretic peptide，B-type natriuretic peptide.3. Statistical methods: We analyze by SPSS19.0softwarepackage, and meet the normal distribution measurement data usingmean and standard deviation, and the measurement were not normallydistribution using median and interquatile.First we test of normality aswithα=0.05significance level.After analysis, baselin LVEF（Z=1.169P=0.13）、 treatment of early LVEF（Z=0.731P=0.659）、treatment ofadvanced LVEF（Z=0.566P=0.905）satisfy the normal distribution, andothers satisfy variable distribution. Baseline ANP average52.00（26.40，127.50），baseline LVEF average（22.96±9.24），baselineNYHA classification average3.00（2.00，3.00），baseline BNP average159.00（66.10,420.00）；Treatment of early LVEF average（28.58±10.20），treatment of early NYHA classification2.00average（2.00，3.00），treatment of early BNP average122.00（50.00,327.00）；Treatmentof advanced LVEF average（35.27±14.00），treatment of advancedNYHA classification average2.00（1.00,2.00），treatment of advancedBNP average97.10（45.48,225.25）.Correlation analysis between eachindex using a simple linear correlation analysis. The comparison of mortality between the group ANP≤52pg/ml and the group ANP＞52pg/ml use the chi-square test. Comparison between other data of thetwo group accord to the following principle: If the two set of data are inline with normal distribution, T-test will be use to compare the meanapplication independence. If there is only one which meet the normaldistribution or nether meet the normal distribution, non-parametric testwill be applied to compare the mean. Statistical result of bilateral P<0.05was considered statistical significanceResult:1.Correlation analysis of baseline ANP with the baselineLVEF, NYHA classification, BNP.Baseline ANP was negatively correlated with baseline LVEF（rs=-0.438P<0.001）.Baseline ANP was positively with baselineNYHA classification（rs=0.595P<0.001）.Baseline ANP was positivelywith baseline BNP（rs=0.843P<0.001）.2.Correlation analysis of baseline ANP with the treatment of earlyLVEF, NYHA classification, BNP.Baseline ANP was negatively correlated with treatment of earlyLVEF （rs=-0.436P=0.001）. Baseline ANP was positively withtreatment of early NYHA classification（rs=0.469P<0.001）. Baseline ANP was positively with treatment of early BNP（rs=0.586P<0.001）。3.Correlation analysis of baseline ANP with the treatment ofadvanced LVEF, NYHA classification, BNP.Baseline ANP was negatively correlated with treatment ofadvanced LVEF（rs=-0.304P=0.017）. Baseline ANP was positivelywith treatment of advanced NYHA classification（rs=0.372P=0.002）.Baseline ANP was positively with treatment of advanced BNP（rs=0.463P<0.001）.4.Correlation analysis of ANP changes of early treatment with LVEF,NYHA classification, BNP changes.Changes in early treatment of ANP and LVEF were negativelycorrelated（rs=-0.311P=0.019）. Changes in early treatment of ANPand BNP were positively correlated (rs=0.765P<0.001). Changes inearly treatment of ANP and NYHA classification were no statisticalsignificance（rs=0.075P=0.554）.5.Correlation analysis of ANP changes of advanced treatment withLVEF, NYHA classification, BNP changesChanges in advanced treatment of ANP and LVEF were negativelycorrelated（rs=-0.384P=0.003）. Changes in advanced treatment ofANP and NYHA classification were positively correlated（rs=0.424 P=0.001）. Changes in advanced treatment of ANP and BNP werepositively correlated（rs=0.645P<0.001）.6. Long-term prognosis of patients with heart failure at baseline ANPlevels.These data will be divided into group ANP≤52pg/ml and groupANP＞52pg/ml by the measured value52pg/ml of ANP. Two group ofage, gender difference was not statistically significant. Two groups werestatistically significant difference in mortality（P<0.05）.Conclusion:1. ANP increased in patient with heart failure prompts poor leftventricular function, manifested as increased NYHA class, declineLVEF.2. Long-term mortality in patient with heart failure with higher ANPhas higher risk of death. The risk of death of group ANP＞52pg/ml is7.3times to the risk of death of group ANP≤52pg/ml.3.Baseline ANP can be a marker of determining the severity of heartfailure and long-term prognosis...