【摘要】 目的:观察左室收缩功能正常的心房颤动(房颤)患者氨基末端-脑钠肽前体(NT-pro-BNP)的变化并探讨其影响因素。方法:对116例左室射血分数正常(LVEF>50％)患者测定血清NT-pro-BNP水平,行经胸超声心动图检查,并调查人口学特征、心血管病主要危险因素情况、合并症、用药情况、血生化学检查。除外既往心功能不全、肝肾功能不全、甲状腺疾病或肿瘤病史患者。结果:持续性房颤血清NT-pro-BNP水平的中位值显著升高(1018．0ng／L比137．9 ng／L,P<0．001),多因素分析发现房颤类型(P<0．0001)、年龄(P=0．0004)、LAD(P<0．0001)是影响NT-pro-BNP的因素,而性别、体重指数、LVEF,房颤的病程和伴随疾病与NT-pro-BNP水平无关。结论:房颤类型,患者年龄和左房内径是房颤患者NT-proBNP升高的独立预测因素。更多还原

【Abstract】 Objective: N-terminal pro-brain natriuretic peptide (NT-proBNP) re sensitive biomarkers of cardiac contractile dysfunction. Several studies have reported that plasma BNP levels are increased in patients with atrial fibrillation (AF). The objective of this study was to assess the factors influencing plasma NT-proBNP levels in patients with AF and preserved left ventricular systolic function. Methods:Study subjects with electrocardiographic evidence of at least one episode of AF and left ventricular ejection fraction (LVEF) >50% on echocardiography were enrolled. Subjects were excluded if they had a history of heart failure, hyperthyroidism, or renal dysfunction. Plasma N-terminal pro-BNP (NT-pro-BNP) levels were determined with the automated Roche NT-proBNP assay and transthoracic echocardiography was routinely performed. The demographic characters, cardiovascular risk factors, complicated diseases, and medications were collected. Results: A totall of 116 patients (67 men, mean age 65. 6±11. 8 years) with paroxysmal (n = 53) or persistent AF (n =63) were enrolled. Median levels of NT-pro-BNP were significantly elevated in subjects with persistent AF as compared with paroxysmal AF subjects (1018. 0 ng/L vs. 137. 9 ng/L, P< 0. 001). In stepwise multiple linear regression analysis, the type of AF, patient age and LAD independently predicted plasma NT-pro-BNP levels in the study subjects. Conclusion :The type of AF, the patient age and LAD are independent predictors of plasma NT-proBNP levels in patients with AF and preserved left ventricular systolic function.更多还原