The Diagnostic Value Of Plasma BNP And Risk Factors For The Heart Failure With Preserved Ejection Fraction

Objectives This study was to analyze the change and value of plasma brain natruretic in the diagnosis of heart failure with preserved ejection fraction(HFPEF) and to determine the risk factors and comorbidity for HFPEF.Methods Sixty-five patients admitted to the affiliated hospital of Hebei University from Jan.1st 2015 to Oct.30 th 2015 were enrolled in this study. Patients enrolled into the study had the examination of echocardiography, left ventricular ejection fraction(LVEF)lower than 45% was excluded, at the same time recorded the patients' general condition,comorbidity and blood tests and measured plasma brain natriuretic peptide(BNP). According to the diagnostic criteria of the Chinese heart failure diagnosis and treatment guidelines, they were divided into asymptomatic left ventricular diastolic dysfunction group(ADD group, n=34) and HFPEF group(n = 31). Echocardiographic parameters and BNP were compared between two groups.Result The study showed that the proportion of female was more than male in both ADD group and HFPEF group. Age, hypertension, anemia, coronary artery disease(CAD),chronic obstructive pulmonary disease( COPD), renal dysfunction, hypoproteinemia were obvious(P?0.05). The level of BNP in HFPEF group was significantly higher than ADD group(P < 0.01). In HFPEF group EDD, ESD, LVPWT, IVST, E/ e', LAd, LAV, and LAVI were higher(P < 0.05), in the contrast, e' and E/A ratio were lower(P < 0.05). According to correlation analysis, LVEDD, IVST, LVPWT, LAd, LAV, LAVI and plasma BNP were positively correlated(P < 0.05). LVEF, IVRT, e'was negatively correlated with plasma BNP(P < 0.05). In HFPEF patients, plasma BNP levels increased with the elevation of NYHA classification. The area under the ROC curve of plasma BNP in diagnosing HFPEF was 0.843.When BNP was 130.0pg/ml, the sensitivity and specificity for diagnosing HFPEF were80.6% and 73.5% respectively. Logistic regression analysis indicated that advanced age,obesity and hypertension were independent risk factors in HFPEF patients.Conclusions HFPEF is more prevalent in women and is more common with aging.Plasma BNP combined with echocardiographic parameters would be valuable for diagnosis of HFPEF. Advanced age, obesity and hypertension were independent risk factors for HFPEF patients, and anemia, CAD, renal dysfunction, hypoproteinemia, COPD were more prevalentin these patients.