Early predictive values of NT-proBNP for acute myocardial ischemia related heart failure with preserved ejection fraction

LIU Xing; ZHANG Dong; WANG Yang-gan

doi:10.3969/j.issn.1674-4055.2017.03.15

Abstract：Objective To evaluate the early predictive values of N-terminal pro-brain natriuretic peptide (NT-proBNP) for acute myocardial ischemia patients related heart failure with preserved ejection fraction (HFpEF). Methods Three hundred and nine hospitalized patients with chest pain in cardiovascular department of Zhongnan Hospital of Wuhan University from September 2015 to April 2016 were enrolled and divided into three groups: <50 years, 50~75 years, and >75 years. Among each group, all patients were further divided into normal group, unstable angina pectoris (UA) group, and acute myocardial infarction (AMI) group according to the results of coronary artery angiography. The predictive values of NT-proBNP for acute myocardial ischemia related HFpEF were evaluated by serum NT-proBNP levels, left atrial diameter (LAD), and New York Heart Association (NYHA) cardiac functional grading.Results There is no significant difference in basic condition (including a variety of clinical factors, such as gender, smoking, serum lipid metabolism, liver and renal function, blood routine test and complications) among all included patients (P>0.05). The serum NT-proBNP levels were positively correlated with severity of coronary arteries in both UA and AMI group among all ages. The greater the number of lesion vessels, the greater the LAD (P<0.05). And the more coronary artery lesions indicated more significant increase in serum NT-proBNP (P<0.05). In UA and AMI groups, LAD was obviously increased in patients with HFpEF (NYHA class II-IV) compared with normal people (NYHA class I), but it is only significantly different in 50-75 years, and >75 years UA groups (P<0.05). The result of correlation analysis showed that, the serum NT-proBNP levels and LAD were positively correlated with coronary artery lesions and HFpEF in different age groups. In 50-75 years' group, the area of NT-pro BNP under ROC for predicting HFpEF was 0.947 (95%CI: 0.918~0.975), and the corresponding cutoff point was 516.5 pg/ml with 0.886 of sensitivity and 0.912 of specificity.Conclusions NT-proBNP plays a crucial role in the early prediction of acute myocardial ischemia and relevant HFpEF.