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首页> 外文期刊>Thrombosis and Haemostasis: Journal of the International Society on Thrombosis and Haemostasis >NT-pra-BNP levels In patients with acute pulmonary embolism are correlated to right but not left ventricular volume and function
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NT-pra-BNP levels In patients with acute pulmonary embolism are correlated to right but not left ventricular volume and function

机译：急性肺栓塞患者的NT-pra-BNP水平与右但左心室容积和功能无关

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摘要

N-termtnal pro-Brain Natriuretic Peptide (NT-pro-BNP) is primarily secreted by left ventricular (LV) stretch and wall tension. Notably, NT-pro-BNP is a prognostic marker in acute pulmonary embolism (PE), which primarily stresses the right ventricle (RV). We sought to evaluate the relative contribution of the RV to NT-pro-BNP levels during PE. A post-hoc analysis of an observational prospective outcome study In 113 consecutive patients with computed tomography (CT)-proven PE and 226 patients in whom PE was clinically suspected but ruled out by CT. In all patients RV and LV function was established by assessing ECG-trig-gered-CT measured ventricular end-diastolic-volumes and ejection fraction (EF). NT-pro-BNP was assessed in all patients. The correlation between RV and LV end-diastolic-volumes and systolic function was evaluated by multiple linear regression corrected for known con-founders. In the PE cohort increased RVEF (p-coefficient (95% confidence interval [Cl]) -0.044 (+- -0.011); p<0.001) and higher RV end-diastolic-volume (p-coefficient 0.005 (+- 0.001); p<0.001) were significantly correlated to NT-pro-BNP, while no correlation was found with LVEF (P-coefficient 0.005 (+- 0.010); p=0.587) and LV end-diastolic-vol-ume (p-coefficient -0.003 (+- 0.002); p=0.074). In control patients without PE we found a strong correlation between NT-pro-BNP levels and LVEF (P-coefficient -0.027 (+- -0.006); p<0.001) although not LV end-diastolic-volume (p-coefficient 0.001 (+- 0.001); p=0.418). RVEF (p-co-efficient -0.002 (+- -0.006); p=0.802) and RV end-diastolic-volume (P-coefficient <0.001 (+- 0.001); p=0.730) were not correlated in patients without PE. In PE patients, lower RVEF and higher RV end-diastolic-volume were significantly correlated to NT-pro-BNP levels as compared to control patients without PE.These observations provide patho-physiological ground for the well-known prognostic value of NT-pro-BNP in acute PE.
机译：N端脑前利钠肽（NT-pro-BNP）主要由左心室（LV）舒张和壁张力分泌。值得注意的是，NT-pro-BNP是急性肺栓塞（PE）的预后标志物，该栓塞主要压迫右心室（RV）。我们试图评估RV在PE期间对NT-pro-BNP水平的相对贡献。对一项观察性前瞻性结果研究的事后分析，对113例经X线断层扫描（CT）证实的PE和226例临床怀疑PE但被CT排除的PE患者进行了分析。在所有患者中，通过评估ECG-trig-gered-CT测量的心室舒张末期容积和射血分数（EF）来确定RV和LV功能。在所有患者中评估了NT-pro-BNP。 RV和LV舒张末期容积与收缩功能之间的相关性通过针对已知混杂因素校正的多元线性回归进行评估。在PE队列中，RVEF增加（p系数（95％置信区间[Cl]）-0.044（+--0.011）; p <0.001）和更高的RV舒张末期容积（p系数0.005（+-0.001） ; p <0.001）与NT-pro-BNP显着相关，而与LVEF（P系数0.005（+-0.010）; p = 0.587）和LV舒张末期容积（p系数）无相关性-0.003（±0.002）; p = 0.074）。在没有PE的对照患者中，我们发现NT-pro-BNP水平与LVEF之间有很强的相关性（P系数-0.027（+--0.006）; p <0.001），尽管左室舒张末期容积却不明显（p系数0.001（ + -0.001）; p ＝ 0.418）。没有PE的患者中RVEF（p系数-0.002（+--0.006）; p = 0.802）和RV舒张末期容积（P系数<0.001（+/- 0.001）; p = 0.730）不相关。在PE患者中，与没有PE的对照组相比，较低的RVEF和较高的RV舒张末期容积与NT-pro-BNP水平显着相关。这些观察结果为众所周知的NT-pro预后价值提供了病理生理基础。 -BNP在急性PE中。

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