The Comparison Of NT-proBNP And ET Levels Between Left And Right Ventricular Dysfunction

Objective:To investigate the concentrations of N-terminal pro-brain natriuretic peptide(NT-proBNP),endothelin(ET) and the indexes of ventricular function examed by ultrasonic cardiogram(UCG) in patients with heart failure.To study the roles of NT-proBNP and ET on cardiac function evaluation and diagnosis of heart failure.To compare NT-proBNP and ET levels in patients between left and right ventricular dysfunction.The relationship between NT-proBNP and ET was also studied.Methods:Ninety-six patients were included in the study.The patients were divided into 4 groups:the left ventricular systolic dysfunction group,the left ventricular diastolic dysfunction group,the right ventricular dysfunction group,and the control group.The left ventricular dysfunction group were divided into 3 groups:NYHAⅡ,NYHAⅢ,NYHAⅣ.NT-proBNP and ET were measured in all subjects.Results:1.In the left ventricular systolic dysfunction group,the left ventricular diastolic dysfuncton group and the right ventricular dysfunction group,the concentrations of NT-proBNP and ET were much higher than that of control group(97.60±84.43pg/ml),(P=0.000).Among the four groups,the concentration of NT-proBNP was highest in the left ventricular systolic dysfunction group(2743.47±2276.52pg/ml),second in the left ventricular diastolic dysfunction group(446.94±415.76pg/ml),third in the right ventricular dysfunction group(387.24±333.46pg/ml).2.Among the four groups,the concentration of ET in the left ventricular diastolic dysfunction group(39.17±24.49ng/L) was much lower than that of left ventricular systolic dysfunction group(55.31±33.62ng/L) or right ventricular dysfunction group(54.04±38.15ng/L),but showed higher concentration than that in the control group(15.98±12.37ng/L),(P=0.000).3.There were significant differences of NT-proBNP levels among NYHA classes in left ventricular dysfunction group(NYHAⅡ:189.46±161.47pg/ml,NYHAⅢ:770.43±727.69pg/ml,NYHAⅣ:2782.69±2470.11pg/ml),(P=0.001).4.There were significant differences of ET levels among NYHA classes in left ventricular dysfunction group(NYHAⅡ:31.42±20.57ng/L,NYHAⅢ:45.18±21.41ng/L,NYHAⅣ:60.38±38.64ng/L),(P=0.013).5.In the left ventricular dysfunction group,the concentration of NT-proBNP was positively correlated with ET(r=0.407,P=0.001),and negatively correlated with LVEF(r=-0.430,P=0.000),and positively correlated with LVEDD(r=0.451,P=0.000).The concentration of ET negatively correlated with LVEF(r=-0.272,P=0.033),and positively correlated with LVEDD(r=0.256,P=0.045) Conclusion:1.NT-proBNP and ET could diagnose heart failure.2.The concentration of NT-proBNP in patients with left ventricular dysfunction was much higher than that with right ventricular dysfunction,the concentrations of NT-proBNP and ET in patients with left ventricular systolic dysfunction were much higher than that in left ventricular diastolic dysfunction.3.NT-proBNP and ET were positively correlated with NYHA classification,they could predict severity of heart failure.4.NT-proBNP in patients with left ventricular dysfunction was positively correlated with ET,NT-proBNP and ET might possess important significance in development of CHF.5.NT-proBNP had good correlation with UCG.