Research On The Correlation Between Essential Hypertension Patients With Single Diastolic Heart Failure And Plama N-Terminal Pro-B-type Natriuretic Peptide

Objective Based on the assay for the N-Terminal pro-B-type Natriuretic Peptide(NT-proBNP) inplasma of essential hypertension patients with single diastolic heart failure(DHF),discuss thecorelation of plasma NT-proBNP and DHF, and finds a appropriate cut-off point about DHF accordingthis research.At same time,watch out the ralations between age,blood presure,body mass index(BMI),Tei index.myocardial model etc and plasma NT-proBNP.Methods In 2005.6—2006.6 we selected some patients diagnosed for essential hypertension inour intracardiac out-patient department and wards. After strict two-dimensional and Dopplerechocardiography check,we divided them to three groups: the elemental hypertension patients withDHF—the hypertension reserch group(36cases),the elemental hypertension patients without DHF—thehypertension contrast group(27cases),the healthy volunteers—the healthy contrast group(28cases),excluded systolic heart failure. primary pulmonary bronchia disease and chronical primary renaldisease. All patients were recorded in detail for age, tallness, time about disease, drug and physiologybiochemical measure etc,and examined plasma samples in same batch number reagents and sameassay machine. Recorded all results, statistical analysis by SPSS.RESULTS(1)In hypertension research group, it was found that the patients with DHF hadhigher concentration plasma NT-proBNP than other two groups(p＜0.0001),when the plasmaNT-proBNP concentration cut-off is 1200pg/ml,the sensitivity is 82.4％,the speciality is 79.3％, thepositive predict value is 51.2％,the negative predice value is 87.4; when the plasma NT-proBNPconcentration cut-off is 1400pg/ml,the sensitivity is 91.3％,the speciality is 73.6％, the positive predictvalue is 60.7％,the negative predice value is 90.1％,AUC is 0.815,9％% confident range is 0.768／0.896;(2) the plasma NT-proBNP concentration had obvious correlation with heart function(NYHAclassification);There is a distinct difference among different myocardial models for the plasmaNT-proBNP concentration;Tei index and left ventricle mass index(LVMI) had obvious correlation withthe plasma NT-proBNP concentration(r=0.82,0.84, P＜0.001);The e/a and A-Ar had higher correlationwith the plasma NT-proBNP concentration(r=-0.78,-0.71,P＜0.001); (3)simple hypertension had lowerplasma NT-proBNP concentration compared hypertension combined with coronary disease anddiabetes etc,but the difference was not distinct(p＜0.05); the plasma NT-proBNP concentration hadn'tobvious correlation with period of hypertension(r=0.43,p＞0.05),but it had distinct correlation with thecontrol conditions of hypertension(r=0.64,p＜0.01).(4) In the hypertension compared group,we foundthe plasma NT-proBNP concentration had higher than the healthy volunteer group(p＜0.001),it wasrelated to the control of hypertension(r=0.68, P＜0.01).(5) In healthy volunteer group, it was foundthat the plasma NT-proBNP concentration had negative correlation with body mass index(BMI),(R=-0.62, P＜0.05),had low correlation with age and smoking,had no correlation with gender. CONCLUSION (1) The patients in the elementary hypertension combined DHF had higherplasma NT-proBNP concentration,that may acts as assistant probe,and help estimating the conditionand effects of therapy;when the plasma NT-proBNP concentration is 1400pg/ml,it has higher sentisiveand special value for diagnosis of DHF; (2) As a biochemical indicator, it has higher and sentisive andspecial than indicators of ultrasonic;(3)In the patients in the elementary hypertension without DHF, theplasma NT-proBNP concentration had increased already, it got direct ratio with blood pressure;theplasma NT-proBNP concentration was affinitive correlation to LVMI,myocardial models,heartfunction classification,the control conditions for hypertension etc;(4)In the general population, theplasma NT-proBNP concentration was related to the age,smoking and BMI.