BACKGROUND: The level of the inactive N-terminal fragment of pro-brain(B-type) natriuretic peptide(BNP)-is a strong predictor of mortality among patients with acute coronary syndromes and may be a strong prognostic ma...BACKGROUND: The level of the inactive N-terminal fragment of pro-brain(B-type) natriuretic peptide(BNP)-is a strong predictor of mortality among patients with acute coronary syndromes and may be a strong prognostic marker in patients with chronic coronary heart disease as well. We assessed the relationship between N-terminal pro-BNP(NT-pro-BNP) levels and long-term mortality from all causes in a large cohort of patients with stable coronary heart disease. METHODS: NT-pro-BNP was measured in baseline serum samples from 1034 patients referred for angiography because of symptoms or signs of coronary heart disease. The rate of death from all causes was determined after a median follow-up of nine years. RESULTS: At follow-up, 288 patients had died. The median NT-pro-BNP level was significantly lower among patients who survived than among those who died(120 pg per milliliter[interquartile range, 50 to 318] vs. 386 pg per milliliter[interquartile range, 146 to 897], P< 0.001). Patients with NT-pro-BNP levels in the highest quartile were older, had a lower left ventricular ejection fraction(LVEF) and a lower creatinine clearance rate, and were more likely to have a history of myocardial infarction, clinically significant coronary artery disease, and diabetes than patients with NT-pro-BNP levels in the lowest quartile. In a multivariable Cox regression model, the hazard ratio for death from any cause for the patients with NT-pro-BNP levels in the fourth quartile as compared with those in the first quartile was 2.4(95 percent confidence interval, 1.5 to 4.0; P< 0.001); the NT-pro-BNP level added prognostic information beyond that provided by conventional risk factors, including the patients age; sex; family history with respect to ischemic heart disease; the presence or absence of a history of myocardial infarction, angina, hypertension, diabetes, or chronic heart failure; creatinine clearance rate; body-mass index; smoking status; plasma lipid levels; LVEF; and the presence or absence of clinically significant coronary展开更多
目的应用超声心动图组织多普勒技术评价右室心尖部起搏对左室收缩同步性及心脏功能的影响,探讨起搏诱发的心室不同步收缩对于心脏功能的影响机制。方法65例置入双腔起搏器的病窦综合征患者分别在心室节律全部为起搏节律或室上性节律状...目的应用超声心动图组织多普勒技术评价右室心尖部起搏对左室收缩同步性及心脏功能的影响,探讨起搏诱发的心室不同步收缩对于心脏功能的影响机制。方法65例置入双腔起搏器的病窦综合征患者分别在心室节律全部为起搏节律或室上性节律状态下行常规及组织多普勒超声心动图检查,测量左室收缩功能及收缩同步性指标。结果右室完全起搏模式下左室收缩功能下降(射血分数:0.58±0.07 vs 0.61±0.01,P<0.001),左室6节段收缩期平均速度下降(4.0±1.5cm/s vs 4.7±1.6cm/s,P<0.001),心室收缩同步性下降(12节段达峰时间标准差:37.5±12.5ms vs 23.7±10.2ms,P<0.001),心室同步性恶化程度与收缩功能恶化中度相关(r=0.37,P<0.05)。结论右室心尖部起搏可致左室收缩不同步及左室功能降低。展开更多
文摘BACKGROUND: The level of the inactive N-terminal fragment of pro-brain(B-type) natriuretic peptide(BNP)-is a strong predictor of mortality among patients with acute coronary syndromes and may be a strong prognostic marker in patients with chronic coronary heart disease as well. We assessed the relationship between N-terminal pro-BNP(NT-pro-BNP) levels and long-term mortality from all causes in a large cohort of patients with stable coronary heart disease. METHODS: NT-pro-BNP was measured in baseline serum samples from 1034 patients referred for angiography because of symptoms or signs of coronary heart disease. The rate of death from all causes was determined after a median follow-up of nine years. RESULTS: At follow-up, 288 patients had died. The median NT-pro-BNP level was significantly lower among patients who survived than among those who died(120 pg per milliliter[interquartile range, 50 to 318] vs. 386 pg per milliliter[interquartile range, 146 to 897], P< 0.001). Patients with NT-pro-BNP levels in the highest quartile were older, had a lower left ventricular ejection fraction(LVEF) and a lower creatinine clearance rate, and were more likely to have a history of myocardial infarction, clinically significant coronary artery disease, and diabetes than patients with NT-pro-BNP levels in the lowest quartile. In a multivariable Cox regression model, the hazard ratio for death from any cause for the patients with NT-pro-BNP levels in the fourth quartile as compared with those in the first quartile was 2.4(95 percent confidence interval, 1.5 to 4.0; P< 0.001); the NT-pro-BNP level added prognostic information beyond that provided by conventional risk factors, including the patients age; sex; family history with respect to ischemic heart disease; the presence or absence of a history of myocardial infarction, angina, hypertension, diabetes, or chronic heart failure; creatinine clearance rate; body-mass index; smoking status; plasma lipid levels; LVEF; and the presence or absence of clinically significant coronary
文摘目的应用超声心动图组织多普勒技术评价右室心尖部起搏对左室收缩同步性及心脏功能的影响,探讨起搏诱发的心室不同步收缩对于心脏功能的影响机制。方法65例置入双腔起搏器的病窦综合征患者分别在心室节律全部为起搏节律或室上性节律状态下行常规及组织多普勒超声心动图检查,测量左室收缩功能及收缩同步性指标。结果右室完全起搏模式下左室收缩功能下降(射血分数:0.58±0.07 vs 0.61±0.01,P<0.001),左室6节段收缩期平均速度下降(4.0±1.5cm/s vs 4.7±1.6cm/s,P<0.001),心室收缩同步性下降(12节段达峰时间标准差:37.5±12.5ms vs 23.7±10.2ms,P<0.001),心室同步性恶化程度与收缩功能恶化中度相关(r=0.37,P<0.05)。结论右室心尖部起搏可致左室收缩不同步及左室功能降低。