中华心律失常学杂志
中華心律失常學雜誌
중화심률실상학잡지
CHINESE JOURNAL OF CARDIAC ARRHYTHMIAS
2013年
4期
271-274
,共4页
杨新玮%华伟%王靖%丁立刚%刘志敏%李崇强%陈柯萍%张澍
楊新瑋%華偉%王靖%丁立剛%劉誌敏%李崇彊%陳柯萍%張澍
양신위%화위%왕정%정립강%류지민%리숭강%진가평%장주
心力衰竭%心脏再同步治疗%大内皮素1%氨基末端B型脑钠肽前体
心力衰竭%心髒再同步治療%大內皮素1%氨基末耑B型腦鈉肽前體
심력쇠갈%심장재동보치료%대내피소1%안기말단B형뇌납태전체
Heart failure%Cardiac resynchronization therapy%Big endothelin-1%NT-proBNP
目的 评价血浆大内皮素l(big ET-1)预测心脏再同步治疗(CRT)反应性的临床价值.方法 本研究回顾性分析了2009年1月至2011年12月间在阜外心血管病医院植入心脏再同步治疗起搏器和/或心脏再同步治疗除颤器(CRT-P/D)的患者.酶联免疫吸附试验(ELISA)测定基线big ET-1及氨基末端B型脑钠肽前体(NT-proBNP)水平,采集基线及随访期心功能(NYHA分级)和超声心动图指标,用Simpson法测定左心室射血分数(LVEF).心功能降低Ⅰ级同时LVEF提高≥0.05定义为有反应；LVEF提高2倍或绝对值≥0.50同时心功能改善至Ⅰ或Ⅱ级定义为超反应.结果 共93例患者入组研究,其中男60例,女33例,平均年龄(60.8±11.0)岁.随访12～50(27±11)个月,无反应34例,有反应24例,超反应35例.3组患者血浆big ET-1水平分别为(1.2±0.9)pmol/L、(0.8±0.4) pmol/L、(0.8±0.6)pmol/L(P=0.003),差异有统计学意义.相关性分析显示血浆big ET-1浓度与NT-proBNP浓度相关(r=0.469,P=0.001).血浆big ET-1水平与CRT反应性相关(r=-0.237,P=0.022).结论 血浆big ET-1与心力衰竭严重程度相关.它是慢性心力衰竭患者CRT反应性的预测指标,与CRT反应呈负相关.big ET-1高预示患者对CRT无反应.
目的 評價血漿大內皮素l(big ET-1)預測心髒再同步治療(CRT)反應性的臨床價值.方法 本研究迴顧性分析瞭2009年1月至2011年12月間在阜外心血管病醫院植入心髒再同步治療起搏器和/或心髒再同步治療除顫器(CRT-P/D)的患者.酶聯免疫吸附試驗(ELISA)測定基線big ET-1及氨基末耑B型腦鈉肽前體(NT-proBNP)水平,採集基線及隨訪期心功能(NYHA分級)和超聲心動圖指標,用Simpson法測定左心室射血分數(LVEF).心功能降低Ⅰ級同時LVEF提高≥0.05定義為有反應；LVEF提高2倍或絕對值≥0.50同時心功能改善至Ⅰ或Ⅱ級定義為超反應.結果 共93例患者入組研究,其中男60例,女33例,平均年齡(60.8±11.0)歲.隨訪12～50(27±11)箇月,無反應34例,有反應24例,超反應35例.3組患者血漿big ET-1水平分彆為(1.2±0.9)pmol/L、(0.8±0.4) pmol/L、(0.8±0.6)pmol/L(P=0.003),差異有統計學意義.相關性分析顯示血漿big ET-1濃度與NT-proBNP濃度相關(r=0.469,P=0.001).血漿big ET-1水平與CRT反應性相關(r=-0.237,P=0.022).結論 血漿big ET-1與心力衰竭嚴重程度相關.它是慢性心力衰竭患者CRT反應性的預測指標,與CRT反應呈負相關.big ET-1高預示患者對CRT無反應.
목적 평개혈장대내피소l(big ET-1)예측심장재동보치료(CRT)반응성적림상개치.방법 본연구회고성분석료2009년1월지2011년12월간재부외심혈관병의원식입심장재동보치료기박기화/혹심장재동보치료제전기(CRT-P/D)적환자.매련면역흡부시험(ELISA)측정기선big ET-1급안기말단B형뇌납태전체(NT-proBNP)수평,채집기선급수방기심공능(NYHA분급)화초성심동도지표,용Simpson법측정좌심실사혈분수(LVEF).심공능강저Ⅰ급동시LVEF제고≥0.05정의위유반응；LVEF제고2배혹절대치≥0.50동시심공능개선지Ⅰ혹Ⅱ급정의위초반응.결과 공93례환자입조연구,기중남60례,녀33례,평균년령(60.8±11.0)세.수방12～50(27±11)개월,무반응34례,유반응24례,초반응35례.3조환자혈장big ET-1수평분별위(1.2±0.9)pmol/L、(0.8±0.4) pmol/L、(0.8±0.6)pmol/L(P=0.003),차이유통계학의의.상관성분석현시혈장big ET-1농도여NT-proBNP농도상관(r=0.469,P=0.001).혈장big ET-1수평여CRT반응성상관(r=-0.237,P=0.022).결론 혈장big ET-1여심력쇠갈엄중정도상관.타시만성심력쇠갈환자CRT반응성적예측지표,여CRT반응정부상관.big ET-1고예시환자대CRT무반응.
Objective To assess the predictive potency of big endothelin-1 (big ET-1) to response to cardiac resynchronization therapy (CRT).Methods We retrospectively analyzed the data of patients who underwent CRT-P/D implantation from Jan 2009 to Dec 2011.Big ET-1 and NT-proBNP were tested by ELISA kit at baseline.NYHA functional class,echocardiography were evaluated both at baseline and follow-up.Simpson method was applied to measure left ventricular ejection fraction (LVEF).Improvement of LVEF by 0.05 and reduction in NYHA class ≥ 1 grade was defined as responder.Improvement of LVEF by twice or the absolute level ≥ 0.50 with NYHA class Ⅰ or Ⅱ grade was defined as super-responder.Results Overall 93 patients aged (60.8 ± 11.0) years old included in this observational study.During 12 ～ 50 (27 ± 11.0) months follow-up,there were 34 non-responders,24 responders and 35 super-responders.Level of plasma big ET-1 in three groups were (1.2±0.9) pmol/L、(0.8±0.4) pmol/L and (0.8±0.6) pmol/L(P =0.003),respectively.Correlation between big ET-1 and NT-proBNP and between big ET-1 and response to CRT was r =0.469 (P =0.001) and r =-0.237(P=0.022),respectively.Conclusion Plasma big ET-1 correlated with the severity of heart failure.It could serve as a response predictor to CRT.High level of big ET-1 indicated non-responder.
