| Objective: The purpose of this study is to investigate the clinical importance of plasma BNP concentrations on its diagnostisc value of early in hyperthyroid cardiopathy,to evaluate its prognostic value in hyperthyroidism and to direct the treatment of those patients.Methods: Plasma FT3 was measured in patients with hyperthyroidism (HTgroup,n=38) and hyperthyroid cardiopathy (HTC group ,n=22) using radioimmunoassay at baseline and 3 months treatment later .Plasma BNP concentration were measured in all of those patients at baseline and after 3 months treatment using TriageR BNP Test,a ready-to-use device . The plasma BNP concentrations were also tested in 10 health controls (HC group ,n=10). The pulmonary artery systotic pressure (PASP),right ventrical diameter (RVD),left ventrical end diastolic diameter (LVEDD) were also measured using echocardiogram in all of patients. At a cutoff of 100pg/ml of plasma BNP concentration, low BNP hyperthyroidisn group (1BNP group,n=10) and high BNP hyperthyroidism group (hBNP group,n=28) were defined. The hBNP group were randomized divided into two groups: Routine treatment group (hBNP R T group ,n=15)and a large dosage of metoprolol treatment group (hBNP MT group , n=13).Results: 1, The plasma BNP concentions of HTC group was 433.22 + 140.77pg/ml at baseline. Followig the decrease of plasma FT3 and the improvement of heart functions, the plasma BNP level was also decreased to199.91 74.87pg/ml(p<0.001), correlation analysis showed that BNP was positively correlated with the course of disease (r=0.556,p=0.007) N Rvd (r=0.535,p=0.010)LVEDD(r=0.431,p=0.045). Multiple Linear regression equation is BNP =11. 258 X course of disease +5.565 XLVEDD( P value of partial regression coefficient is 0.012, 0.001, respectively). The equation of Linear regression between BNP and PASP is BNP=11.435XPASP(P=0.001). After 3 months treatment, pulmonary hypertesion detection ratio was lower than that of baseline (44.45% vs 72.73%, P=0.015). Before the treatment, RVD dilation ratio was higher than LVEDD dilation rario (90.91% vs 40.91%, P < 0.001). 2, The plasma BNP concentration of HTC group was higher than that of HT group and health control group (433.32+140.77 vs 110.11 38.18> 9.70+3.37, PO.001, respectively) .HT group was also higher than that of health control group (110.11 38.18 vs 9.70 3.37, p<0.001). 3, BNP at a cutoff of 172.37pg/ml, the diagnosis of hyperthyroid cardiopathy sensitivity was 95.45%, specificity was 92.11%, PAH detected by echocardiogram, the diagnosis of hyperthyroid cardiopathy sensitivity was 72.73%, specificity was 89.47%. This sensitivity of BNP was higher than that of pulmonary artery hypertension(PAH)(U=2.06,/)<0.05).The comparison of specitivity both BNP and PAH showed no statistic difference (u=0.398,p>0.05). 4, After 3 months treatment,compared with hBNP RT group , hBNP MT group showed a decrease in HR (71.77 + 6.11 VS 92.80 + 8.60 beats/mm,p=0.001), PDD(39.62 + 8.28 vs 49.67 + 8.12 mmHg ,p=0.003) and BNP (25.77+12.73 vs 64.73 + 47.54pg/ml,p=0.008). The morbility of hyperthyroid cardiopathy comparison between hBNP MT group and hBNP RT group(26.67%) showed a significant difference (p=0.018). 5 , The comparison of hyperthyroid cardiopathy morbility in both 1BNP group and hBNP RT group (27.67%) also showed a statistic difference (p=0.032).Conclusions: 1 , The plasma concentration of BNP, at a cutoff 172.37pg/ml , showed a high sensitivity and specificity in early diagnosis of hyperthyroid cardiopathy in patents with hyperthyroidism ,and had a higher sensitivity than pulmonary artery hypertension detection by echocardiogram. 2, In patients with hyperthyroid cardiopathy, right ventricule was easier damaged than left ventricule. 3, The plasma concentrations of BNP in patients with hyperthyroidism was higher than that of health controls. Hyperthyroidism should be excluded in acute dyspnea diagnosis, when the plasma BNP concentration was used at a cutoff lOOpg/ml. 4, Hyperthyroid cardiopathy was incidental in hyperthyroidism patiedts with higher(more than 100pg/...
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