| Objective: To evaluate the diagnostic value of plasma NT-pro BNPand left ventricular mass index in the elderly normal left ventricular ejec-tion fraction heart failure (HFNEF) patients.Methods: To choose232patients diagnosed heart failure in theDepartment of Cardiology, the First Hospital of Jilin University sinceJanuary2014to December2014.To232cases who were60years old orover, whose heart failure NYHA class were II to IV, had theechocardiography and plasma NT-pro BNP testing24hours afteradmission. According to the results of the left ventricular ejection fraction(LVEF) with echocardiography, the patients were divided into two groups:the group of heart failure with normal ejection fraction (HFNEF)(LVEF≥45%) and the group of reduced ejection fraction heart failure(HFREF)(EF≤40%).Finally,158cases were in the HFNEF group,74cases in the HFREF group, and at the same time, we selected100cases inhealthy people as the control group. To collect the data of systolicechocardiographic left atrial diameter (LAD), end-diastolic leftventricular diameter (LVEDd), interventricular septum thickness (IVST),left ventricular wall thickness (LVPWT), blood routine examination and plasma NT-pro BNP and calculated left ventricular mass index (LVMI)on the basis of echocardiographic results. And then analyzed thequestions as follow：1、The clinical characteristics of HFNEF.2、Theplasma NT-pro BNP and left ventricular mass index, as reflected in thediagnosis of HFNEF whose sensitivity, specificity, positive predictivevalue, negative predictive value are.3、 The plasma NT-pro BNP asreflect left ventricular filling pressure of indirect indicators, analyze thecorrelation between left ventricular mass index and plasma NT-proBNP.4、 The relationship between plasma NT-pro BNP and NYHAclass.5、The relationship between left ventricular mass index and NYHAclass.Results:1、 Compared with the healthy control group, the HFNEFgroup patients’ age was significantly increased and incidence ofhypertension was significantly higher, the difference was statisticallysignificant (P <0.01). Compared with HFREF group, the increase of theHFNEF group patients’ age, hypertension incidence and high incidence infemales, were significantly different(P <0.05).2、 Compared with thehealthy control group, the heart failure group paitients’ LVEDd、IVST、LVPWT were increased, the difference was statistically significant (P<0.05).compared with the HFREF group, the increase of the HFNEFgroup patients’IVST、LVPWT, was statistically different (P <0.05),thedecrease of the HFNEF patients’ LVEDd and E/A were statistically different (P <0.05).3、The plasma NT-pro BNP125pg/ml as the criticalvalue, the sensitivity of the HFNEF diagnosis was93.0%, specificity was82.0%, positive predictive value was94.2%, negative predictive valuewas78.8%. with LVMI>122g/m2(Female),>149g/m2(male) as thecritical value, the diagnostic sensitivity of HFNEF was (male18.7%,female47.9%), specificity was (male96%,female99%).4、The plasmaNT-pro BNP as reflect indirect indicators of left ventricular fillingpressure in HFNEF, that left ventricular mass index and plasma NT-proBNP were significant positive correlation (r=0.503, P <0.01).5、 Theplasma NT-pro BNP and left ventricular mass index were increased withworsening NYHA class in HFNEF, the difference was statisticallysignificant between NYHA levels (P <0.05).Conclusions:1、The main risk factors in elderly patients with HFNEF are aged、hypertension and female.2、 The left ventricular hypertrophy in elderlypatients with HFNEF, is concentric hypertrophy change.3、 When theHFNEF group patients’ age, plasma levels of NT-pro BNP and leftventricular mass index increased,the degree of severity of NYHAfunctional classification is significantly increased as well.4、 When theHFREF is exclused, increased plasma NT-pro BNP levels can be used asan indicator of HFNEF diagnosis.5、When the HFREF is exclused, andplasma NT-pro BNP levels have been increased, increased left ventricular mass index is used to assess diastolic dysfunction. |
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