To Assess The Clinical Diagnostic Value Of Left Atrial Volume Index And Brain Natriuretic Peptide For Heart Failure With Normal Left Ventricular Ejection Fraction

【Objective】: Applying left atrial volume index and brain natriuretic peptide to evaluate heart failure of patients with normal left ventricular ejection fraction.【Methods】: Prospectively we studied 54 patients with chronic heart failure,of which 29 patients left ventricular ejection fraction(LVEF)>50% and the rest of them LVEF<45%, and 20 controls. All the subjects were graded by NHYA class ,simultaneously BNP and left atrial volume were measured. 1. Appraise the sensitivity,specificity,positive predict value,negative predict value of BNP in patients with heart failure of patients with normal left ventricular ejection fraction. 2. Using BNP as a surrogate of left ventricular filling pressure,echocardiographic parameters of diastolic function are investigated in correlation with plasma level of NT-pro BNP in patients of diastolic dysfunction to determine which index is the best reflection of diastolic function. 3.Analyze the correlation between BNP and left ventricular diastolic function,the correlation between BNP and NYHA class. 4. Analyze the correlation between left atrial volume index and left ventricular diastolic function,the correlation between left atrial volume index and NYHA class.【Results】: (1)Compared with the control group, the plasma levels of BNP were significantly elevated in both HFNEF and SHF patients.Compared with HFNEF, the plasma levels of BNP were elevated in SHF patients.(2)When BNP=125pg/ml,the sensitivity,specificity,positive predict value and negative predict value of BNP for diagnosing HFNEF were 72.4%,94.1%,91.3%,and respectively 69.2% (3)Accord to correlation,there was remarkable positive correlation between LAVI and LgBNP.(4)In HFNEF patients, the plasma levels of BNP amplification were in proportion to the severity of left ventricular diastolic dysfunction and NYHA class. Among NYHA class, BNP levels were significantly different.(5) In HFNEF patients, the amplification of left atrial volume index was in proportion to the severity of left ventricular dysfunction. Among NYHA class, left atrial volume index was significantly different.【Conclusion】:(1) Plasma levels of BNP and left atrial volume index were significantly elevated in HFNEF patients, and amplification was in proportion to NYHA class and the severity of diastolic dysfunction.(2) After SHF excluded, plasma levels of BNP can serve as a marker used for diagnosis of HFNEF.(3)Transitral inflow velocities and pulmonary venous flow velocities can be inaccurate in evaluating diastolic dysfunction if left ventricular systolic function is normal. But left atrial volume index may evaluate diastolic dysfunction.