Value of NT-ProBNP in evaluating cardiac function in patients with chronic heart failure and its influencing factors

Luo Wei; Li Shaochi; Xu Shangyu; Ou Guangyao

doi:10.3969/j.issn.1674-4055.2019.04.23

Abstract：Objective To analyze the value of N-terminal B-type natriuretic peptide (NT-proBNP) in assessing cardiac function in patients with chronic heart failure and its influencing factors. Methods 267 patients with chronic heart failure admitted to Yulin Second People's Hospital from January 2016 to January 2018 were enrolled in the study. According to the New York Heart Association (NYHA) Heart Function Grading Standard, they were divided into GroupⅡ (72). Example) and group Ⅲ~Ⅳ (195 cases). Plasma NT-ProBNP was determined by electrochemiluminescence method, and the correlation between NT-ProBNP and main indexes of echocardiography was analyzed according to the results of echocardiography. The area under the receiver operating characteristic (ROC) curve (AUC) was used to analyze the diagnostic efficacy of NT-ProBNP for NYHA cardiac function Ⅲ~Ⅳ, and the factors affecting NT-ProBNP were analyzed by single factor and multiple stepwise regression. Results There were no significant differences in left ventricular end-diastolic diameter (LVIDD) and left atrial diameter (LA) between the two groups (P＞0.05). Comparison of plasma NT-ProBNP concentration and left ventricular ejection fraction (LVEF) between the two groups The differences were statistically significant (P＜0.05). According to Pearson correlation analysis, there was a correlation between plasma NT-ProBNP concentration and LA, LVIDD and LVEF in patients with chronic heart failure (P＜0.05). The ROC curve showed that the diagnostic mean value of NT-ProBNP for NYHA cardiac function III to IV was 2400 pmol/L, and the AUC was 0.864, which was significantly greater than 0.780 for LVEF. The difference was statistically significant (P＜0.05); The discriminant AUC was 0.933, which was significantly greater than the 0.864 of NT-ProBNP, and the difference was statistically significant (P＜0.05). After single factor and multivariate stepwise regression analysis, body mass index (BMI), heart rate, serum creatinine (Cre), alanine aminotransferase (ALT), LVEF, LA were independent factors affecting plasma NT-ProBNP concentration ( P＜0.05). Conclusion The plasma NT- proBNP concentration is significantly increased, which can accurately and objectively reflect the cardiac function of patients with moderate to severe chronic heart failure,plasma concentration depends mainly on cardiac function and is also affected by BMI, kidney and liver function.