| BackgroundAt present, the number of patients suffered from heart failure is increasing, as well as those died of this disease, which is seriously threatening their lives and health. It is a complicated clinical syndrome characterized by ventricular dysfunction, neuroendocrine activation and abnormal blood flow distribution, which is the terminal stage of various heart diseases. With the development of clinical medical technology, it is possible for the patients with acute myocardial infarction, congenital heart disease, arrhythmia and other critically ill to survive. With people's average life expectancy increasing, the incidence of heart failure has increased year by year. In order to reduce of the potential mortality and delay the patho-physiological progression of heart failure, the early diagnosis is very important. Previously the clinical diagnosis of heart failure mainly base on the New York Heart Association functional class (NYHA) and echocardiography, ECG, X-ray examination, etc. However, these are subjective and inaccurate. Doctors hope clinical laboratory can provide more objective and effective biochemical indicators to assist the early diagnosis of heart failure. In recent years, the studies suggest that NT-proBNP (N-terminal B-type natriuretic peptide) is an important neuro-hormonal marker of the cardiac function. When ventricular volume increase or ventricular wall stress increase, NT-proBNP is released into the blood by the rapid synthesis of ventricular muscle cells. Its level in plasma is significantly high in patients with congestive heart failure. Plasma NT-proBNP level is not only a good indicator for the early detection of patients with heart failure, but also for the treatment and the predicting of prognosis in patients with heart failure. This study was to detect plasma NT-proBNP levels in patients with heart failure before and after treatment, and to explore the relationship between the level of plasma NT-proBNP and the early diagnosis of cardiac dysfunction, efficacy analysis of therapy and predicting prognosis.ObjectiveThe research is to detect plasma NT-proBNP level in patients with heart failure before and after treatment and explore the relationship between the level of NT-proBNP and the early diagnosis of cardiac dysfunction, as well as the severity of heart failure and predicting prognosis.MethodsThe test group is made up of 120 patients diagnosed with heart failure who got treatment in the cardiovascular department of the First Affiliated Hospital of Zhengzhou University from Feb.2008 to Dec.2008. The control group consists of 46 persons that prove to healthy after body-examination. Plasma NT-pro BNP level is measured by electrochemical luminescence, and left ventricular ejection fractions (LVEF) is detected by color Doppler ultrasound. The relationship between the NT-pro BNP levels and the severity of heart failure, LVEF, and prognosis of the patients with heart failure, of which statistical analysis was made by SPSS 10.0.ResultsThe level of NT-proBNP in plasma of patients with heart failure were significantly higher than that of the control group, The higher the stage of NYHA cardiac function the higher of plasma NT-pro BNP level, which prove to be a positive correlation, while LVEF decline, showing a negative correlation, the differences between the two groups were statistically significant (p<0.05). The plasma NT-proBNP level in patients with heart failure decreased significantly afterlO days' treatment compared with before, and a 6-month follow-up found that patients whose plasma NT-proBNP level is difficult to drop had been prone to suffer clinical endpoint events, while the patients with plasma NT-proBNP level decreased significantly had a better prognosis.ConclusionThere is a close positive relationship between plasma NT-proBNP level and severity of heart failure in patients with cardiac dysfunction. The higher of the plasma NT-proBNP level, the higher stage of the NYHA cardiac functional class (positive relation), and the lower the LVEF values (negative relation). The patients with no NT-pro BNP level dropping significantly have a worse prognosis, while patients with plasma NT-proBNP levels decreased significantly have a better prognosis.In conclusion, it is of great value that the plasma NT-proBNP level for the diagnosis of congestive heart failure, efficacy of therapy and predicting of prognosis. |
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