高血压并发阵发性心房颤动患者的左房形变功能与血清NT-proBNP的相关性

屈文涛; 康亚宁; 许磊; 马静; 苏洁; 王荣荣; 孟翠翠

doi:10.13201/j.issn.1001-1439.2021.02.014

高血压并发阵发性心房颤动患者的左房形变功能与血清NT-proBNP的相关性

- 西安市中医医院超声科(西安, 710021)

详细信息

通讯作者: 许磊,E-mail:283565626@qq.com

中图分类号: R541.7

收稿日期: 2020-09-05

The correlation between N-terminal pro brain natriuretic peptide and left atrial strain function in hypertensive patients with paroxysmal atrial fibrillation by two-dimensional speckle tracking echocardiography

- Department of Ultrasound, Xi'an Hospital of Traditional Chinese Medicine, Xi'an, 710021, China

More Information

Corresponding author: XU Lei, E-mail: 283565626@qq.com

Received Date: 05 September 2020

摘要

摘要: 目的:应用二维斑点追踪技术评估高血压患者并发阵发性心房颤动(房颤)的左房心肌应变功能与血清氨基末端脑钠肽前体(NT-proBNP)的相关性以及左房应变对阵发性房颤的预测价值。方法:选取2018年6月—2019年9月我院单纯高血压患者80例(HT),高血压合并阵发性房颤患者60例(HT+PAF),健康体检对照组50例。测定3组血清NT-proBNP水平,应用二维斑点追踪技术测得左室收缩期左房心肌整体峰值纵向应变(LAS-s),心房收缩期左房心肌整体峰值纵向应变(LAS-a),应用常规超声心动图技术测量左室舒张末内径(LVEDD)、室间隔厚度(IVST)、左房内径(LAD)、左心室射血分数(LVEF)、E/A、E/e′比值、左房整体排空分数(LATEF)、左房容积指数(LAVI)、Tei指数。比较血清NT-proBNP水平与左房各功能参数的相关性,分析高血压患者并发阵发性房颤的影响因素。结果:与对照组比较,HT组、HT+PAF组的NT-proBNP、LAD、LAVI、E/e′、Tei指数依次增高,HT+PAF组增高更为显著(P＜0.05),与对照组比较,HT组、HT+PAF组的LAS-s、LAS-a、LATEF依次减低,HT+PAF组减低更为显著,差异有统计学意义(P＜0.05)。相关分析显示血清NT-proBNP与LAS-s、LAS-a负相关(r=-0.589,r=-0.514,P＜0.05),血清NT-proBNP与年龄、E/e′、LAD、LAVI、Tei指数呈正相关(r=0.432,r=0.484,r=0.504,r=0.512,r=0.482,P＜0.05)。多因素的Logistic回归分析显示年龄、LAS-s、LAS-a是高血压患者并发阵发性房颤的独立影响因素(P＜0.05),LAS-s、LAS-a预测高血压患者并发阵发性房颤的ROC曲线下面积分别为0.706、0.766,最佳截断值为34%、12%。结论:高血压患者并发阵发性房颤的左房心肌纵向形变功能减低,血清NT-proBNP水平与左房结构和功能具有密切相关性,LAS-s、LAS-a是高血压患者并发阵发性房颤的独立影响因素,能够作为高血压并发阵发性房颤的新的预测指标。
- 高血压 /
- 阵发性房颤 /
- 二维斑点追踪技术 /
- 左房应变 /
- NT-proBNP
Abstract: Objective: To evaluate the correlation between N-terminal pro brain natriuretic peptide(NT-proBNP) and left atrial(LA) strain function in hypertensive(HT) patients with paroxysmal atrial fibrillation(PAF) by two-dimensional speckle tracking echocardiography(2 D-STE).Methods: There were 80 patients with hypertensive(HT) and 60 hypertensive patients with hypertensive and paroxysmal atrial fibrillation(HT+PAF) in study groups. The 50 healthy persons served as the control group. NT-proBNP levels of the patients were measured by serum test. LA peak ventricular systolic longitudinal strain(LAS-s) and left atrial longitudinal strain(LAS-a) during atrial systolic period were determined by 2 D-STE. Conventional echocardiography was used to measure the left atrial diameter(LAD), left ventricular end-diastolic diameter(LVEDD), interventricular septum thickness(IVST), left ventricular ejection fraction(LVEF), E/e′, E/A, left atrial total ejection fraction(LATEF), left atrial volume index(LAVI), Tei index.Results: Compared with the control group, the LAS-s, LAS-a, LATEF were significantly lower in HT group and HT+PAF group(P＜0.05). Compared with the control group, the NT-proBNP, LAD, LAVI, E/e′, and Tei index were significantly higher in HT group and HT+PAF group(P＜0.05). Correlation analysis showed that the NT-proBNP was negative correlation with LAS-s, LAS-a(r=-0.589, r=-0.514, respectively; all P＜0.05). The NT-proBNP was positively related age, E/e′, LAD, LAVI, Tei index(r=0.432, r=0.484, r=0.504, r=0.512, r=0.482, respectively; all P＜0.05). Multivariate Logistic regression analysis showed that age, LAS-s and LAS-a were independent risk factors of hypertensive patients with paroxysmal atrial fibrillation.Conclusion: The left atrial deformational function is lower in patients with hypertension and paroxysmal atrial fibrillation. The NT-proBNP level is closely related with left atrial structure and function. In patients with hypertension, LAS-s and LAS-a independently correlate with the paroxysmal atrial fibrillation, and may be used as predictors for paroxysmal atrial fibrillation.
- hypertension /
- paroxysmal atrial fibrillation /
- two-dimensional speckle tracking echocardiography /
- left atrial strain /
- NT-proBNP levels

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