尿性可以预测严重的大动脉狭窄症的无症状存活率和术后结果
Jutta Bergler-Klein1, Ursula Klaar, Maria Heger
1Department of Cardiology and the Ludwig Boltzmann Institute of Cardiovascular Research, University of Vienna, Vienna, Austria.
Circulation
|May 1, 2004
概括
包括N终端BNP (NtBNP) 在内的尿素,在严重的大动脉狭窄 (AS) 中提供了关键的预后见解. 升高的NtBNP水平独立预测无症状生存和术后结果,有助于手术时间.
科学领域:
- 心脏病学 心脏病学
- 临床医学 临床医学
- 生物标志物 生物标志物
背景情况:
- 大动脉狭窄症 (AS) 患者中尿酸的预后意义尚未得到充分确立.
- 大动脉狭窄是一种重要的心血管疾病,需要准确的预后评估.
研究的目的:
- 为了研究 natriuretic的预后价值在患有严重的大动脉狭窄症的患者.
- 为了确定 natriuretic是否可以预测无症状生存和AS患者的术后结果.
主要方法:
- 在130名严重的AS患者中测量B型尿素 (BNP),N终端尿素 (NtBNP) 和N终端心房尿素 (NtANP).
- 对无症状生存和术后结果的后续评估.
- 多变量分析包括临床和心声回声学数据.
主要成果:
- 尿素水平与NYHA类和射出分数 (EF) 相相关,即使在无症状患者中也会升高.
- 无症状患者后来出现症状,与那些没有症状的患者相比,基线NtBNP水平显著更高.
- 升高的NtBNP (<80 pmol/L与>=80 pmol/L) 与明显较低的无症状存活率有关.
- 多变量分析发现NtBNP是患者结果的唯一独立预测因子.
结论:
- 尿素,特别是NtBNP,在严重的AS中提供了重要的预后信息,超出了传统的临床和心声学评估.
- 手术前的NtBNP水平独立预测无症状生存率和术后的结果,包括生存率,症状状态和左心室功能.
- 神经激素水平,特别是NtBNP,对于优化严重AS无症状患者手术介入时间至关重要.
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