B-type Natriuretic Peptide 수치와 이완기 심초음파 파라미터와의 연관성 연구
Studies for B-type Natriuretic Peptide Values and Its Association with Diastolic Echocardiographic Parameters
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
B-type natriuretic peptide (BNP)와 심초음파는 심부전 진단과 예후를 판단하는 지표로써 수축 기능이상에 많은 연구를 했으나, 본 연구에서는 BNP 결과와 심초음파 이완 기능을 나타내는 항목의 상관관계를 알아보고자 한다. BNP 검사와 심초음파를 실시한 188명을 대상으로 BNP 결과에 따라 5그룹으로 분류하고, 심초음파의 좌심실 구혈률, 좌심방 크기, E velocity, A velocity, Deceleration time, E/A ratio, E', A', S', E/E'와의 상관관계를 조사하고, 그 중 심부전을 진단 받은 67명을 Relaxation abnormality (Grade I), Pseudonormalization (Grade II), Restrictive physiology (Grade III)로 등급을 분류하고 BNP 결과와 심초음파 항목을 비교한 결과 BNP 수치가 상승할수록 심초음파 항목 중 좌심실 구혈률, 좌심방 크기, E/A ratio, Deceleration time, A', S', E/E'와 유의한상관관계가 있었다. 그룹간의 비교에서 E/E' 항목이 가장 좋은 유의성을 보여주었다. 심부전 환자의 등급 분류에 따른 BNP 결과는623.0±459.7 pg/mL, 1013.2±1155.1 pg/mL, 1693.4±1544.0 pg/mL로 유의성이 있었으며(p＜0.01), 등급이 올라갈수록 심초음파 항목 중 좌심실 구혈률, 좌심방 크기, E velocity, A velocity, E/A ratio, Deceleration time, A', E/E' 와 상관관계가 있었다(p＜0.001). BNP 결과가 상승할수록 심초음파 이완기 항목과유의성이 있었고, 심초음파에서 Restrictive physiology 그룹의BNP 결과가 가장 높았다.
Abstract
The b-type natriuretic peptide (BNP) values and increase on functional disorder in the ventricle, and are used as an index to diagnose heart failure and predict the prognosis. BNP values is known to be relevant to dyssystole in congestive heart failure. This study aimed to identify correlation between the BNP values and the items that indicate the diastolic function in echocardiography. The research divided 188 patients who went through the BNP test and echocardiography in the hospital into the groups with the BNP values; ＜100, 100-300, 301-600, 601-900, and ＞901 pg/mL. As the BNP values increase, there was relevance with the echocardiography items of ejection fraction, size of left atrium, E velocity, A velocity, Deceleration time, E/A ratio, E', A', S' and E/E'. In comparison on the groups divided based on the BNP values, E/E' had the highest relevance. The research also categorized 67 patients who diagnosed with heart failure. In comparison on the groups of the heart failure patients, the BNP values of the three groups of Grade I: 623.0±459.7 pg/mL, Grade II: 1013.2±1155.1 pg/mL and Grade III: 1693.4±1544.0 pg/mL, respectively (p＜0.01). As the grade was higher, there was a higher relevance with the echocardiography items of ejection fraction, size of left atrium, E velocity, A velocity, Deceleration time, E/A ratio, E', A', S' and E/E' (p＜0.001). Higher BNP values had a higher relevance with the items that indicate the diastolic function in echocardiography and the BNP values of the Restrictive physiology group were the highest in echocardiography. So the BNP values was thought to be valuable to predict diastolic function of heart.
참고문헌 (31)
- Mosterd A, "Prevalence of heart failure and left ventricular dysfunction in the general population-The rotterdam study", Eur Heart J, 20, pp.447~455 (1999)
- Yasue H, "Localization and mechanism of secretion of B-type natriuretic peptide in normal subjects and patients with heart failure", Circulation, pp.195~203 (1994)
- De Lemos JA, "B-type natriuretic peptide in cardiovascular disease", Lancet, 362, pp.316~322 (2003)
- McDonagh TA, "Biochemical detection of left-ventricular systolic dysfunction", Lancet, 351, pp.9~13 (1998)
- Tsutamoto T, "Attenuation of compensation of endogenous cardiac natriuretic peptide system in chronic heart failure. Prognostic role of plasma brain natriuretic peptide concentration in patients with chronic symptomatic left ventricular dysfunction", Circulation, 96, pp.509~516 (1997)
- Harrison A, "B-type natriuretic peptide predicts future cardiac events in patients presenting to the emergency department with dyspnea", Ann Emerg Med, 39, pp.131~138 (2002)
- Dokainish H, "Comparative accuracy of B-type natriuretic peptide and tissue Doppler echocardiography in the diagnosis of congestive heart failure", Am J Cardial, 93, pp.1130~1135 (2004)
- Dokainish H, "Optimal non-invasive assessment of LV filling pressures : a comparison of tissue Doppler echocardiography and BNP in patients with pulmonary artery catheters", Circulation, 109, pp.2432~2439 (2004)
- Nagueh SF, "Hemodynamic determinants of the mitral annulus diastolic velocities by tissue Doppler", J Am Coll Cardiol, 37, pp.278~285 (2001)
- Sohn DW, "Assessment of mitral annulus velocity by Doppler tissue image in the evaluation of left ventricular diastolic function", J Am Coll Cardiol, 30, pp.474~480 (1997)
- Nagueh SF, "Doppler tissue imaging : A noninvasive technique for evaluation of left ventricular relaxation and estimation of filling pressures", J Am Coll Cardiol, 30, pp.1527~1533 (1997)
- Ono M, "Doppler echocardiography-derived index of myocardial performance(TEI index)-comparison with brain natriuretic peptide levels in various heart disease", Jpn Circ J, 65, pp.637~642 (2001)
- Senni M, "Use of echocardiography in the management of congestive heart failure in the community", J Am Coll Cardiol, 33, pp.164~170 (1999)
- Zile M, "New concepts in diastolic dysfunction and diastolic heart failure: Park I. Diagnosis, prognosis, and measurements of diastolic function", Circulation, 105, pp.1387~1393 (2002)
- Maisel AS, "Breathing Not Properly Multinational Study Investigators. Bedside B-Type natriuretic peptide in the emergency diagnosis of heart failure with reduced or preserved ejection fraction. Result from the Breathing Not Properly Multinational Study", J Am Coll Cardiol, 41(11), pp.2010~2017 (2003)
- Schiller NB, "Recommendations for quantification of the left ventricle by two-dimensional echocardiography", J Am Soc Echocardriogr, 2, pp.358~367 (1989)
- Appleton CP, "Doppler evaluation of left and right ventricular diastolic function : a technical guide for obtaining optimal flow velocity recordings", J Am Soc Echocardiogr, 10, pp.271~291 (1997)
- Cowie MR, "BNP and congestive heart failure", Curr Probl Cardiol, 44, pp.264~310 (2003)
- Tomas J, "Natriuretic peptides in unstable coronary artery disease", Eur Heart J, 25, pp.1486~1493 (2004)
- Yasue H, "Localization and mechanism of secretion of B-type natriuretic peptide in comparison with those of A-type natriuretic peptide in normal subjects and patients with heart failure", Circulation, 90, pp.195~203 (1994)
- McGregor A, "Brain natriuretic peptide administered to man : Actions and metabolism", J Clin Endocrinol Metab, 70, pp.1103~1107 (1990)
- Magga J, "Involvement of transcriptional and posttranscriptional mechanisms in cardiac overload-induced increase of B-type natriuretic peptide gene expression", Circ Res, 81, pp.694~702 (1997)
- Yoshibayashi M, "Plasma brain natriuretic peptide concentration in healthy children from birth to adolescence : marked and rapid increase after birth", Eur J Endocrinol, 133, pp.207~209 (1995)
- Koglin J, "Role of brain natriuretic peptide in risk stratification of patients with congestive heart failure", J Am Coll Cardiol, 38, pp.1934~1941 (2001)
- Vasan RS, "Prevalcence, clinical features and prognosis of diastolic heart failure : an epidemiologic perspective", J Am Coll Cardiol, 26, pp.1565~1574 (1995)
- Senni M, "Congestive heart failure in the community : a study of all incident cases in Olmstead County, Minnesota, in 1991", Circulation, 98, pp.2282~2289 (1998)
- Dao Q, "Utility of B-type natriuretic peptide in the diagnosis of CHF in an urgent care setting", J Am Coll Cardiol, 37, pp.379~385 (2001)
- Morrison KL, "Utility of a rapid B-natriuretic peptide assay in differentiating CHF from lung disease in patients presenting with dyspnea", J Am Coll Cardiol, 39, pp.202~209 (2002)
- Davies MK, "ABC of heart failure;investigation", BMJ, 320, pp.297~300 (2003)
- Isaaz K, "Doppler echocardiographic measurement of low velocity motion of the left ventricular posterior wall", Am J Cardiol, 64, pp.66~75 (1989)
- Lubien E, "Utility of B-natriuretic peptide in detecting diastolic dysfunction : comparison with doppler velocity recordings", Circulation, 105, pp.595~601 (2002)