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|本期目录/Table of Contents|

脑钠尿肽可用于预测孤立性房颤的血栓事件及房颤复律与再发(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2007年第4期
页码:
467-470
栏目:
临床研究
出版日期:
2007-08-01

文章信息/Info

Title:
BNP is an independent predictor of thromboembolism, failed cardioversion and recurrence with lone atrial fibrillation
作者:
肖春晖; 李肖蓉; 羊镇宇; 吴小庆; 王如兴
南京医科大学附属无锡第一医院、无锡市第一人民医院心内科, 江苏 无锡 214002
Author(s):
XIAO Chunhui;  LI Xiaorong;  YANG Zhenyu;  WU Xiaoqing;  WANG Ruxing
Department of Cardiology, First People′s Hospital of Wuxi City, First Affiliated Hospital of Nanjing Medical University, Wuxi 214002, Jiangsu , China
关键词:
脑钠尿肽; 心房颤动; 血栓事件; 复律
Keywords:
brain natriuretic peptide;  thromboembolism ; cardioversion;  lone atrial fibrillation
分类号:
R541.7
DOI:
-
文献标识码:
A
摘要:
目的 探讨脑钠尿肽(BNP)与孤立性心房颤动（AF）的血栓事件发生、复律及再发之间的关系。方法 103例孤立性AF 患者行食道超声(TEE)、头颅CT/MRI检查及血BNP测定。根据血栓事件将患者分为血栓事件组（n=15）和无血栓事件组（n=88）。对于有复律指征的患者，根据AF复律情况分为复律失败组（包括即刻复律失败和随访期内再发，n=16）和复律成功组(复律成功并随访期内维持窦性心律，n=7)。分别进行对比研究。结果 血栓事件组较无血栓事件组BNP水平高［(150±43) ng/L vs (84±40 )ng/L, P<0.05］。复律失败组较成功组BNP水平高［(178±70 )ng/L vs (60±32 )ng/L, P<0.05］、病程长［(8±3)月 vs (3±2)月，P<0.05］和左房内径(LAD) 扩大［(49±5)mm vs (42±3)mm , P<0.05］。多因素Logistic回归分析: BNP是预测孤立性AF血栓事件的独立危险因素(P<0.05)；BNP、LAD和AF病程是预测AF复律是否成功的独立危险因素(均P<0.05)。结论 BNP可作为预测孤立性AF血栓事件和AF复律与再发的临床指标。
Abstract:
AIM To assess relationships between the BNP (plasma brain natriuretic peptide) levels and the risk for thromboembolism, successful cardioversion and maintenance of sinus rhythm in patients with lone atrial fibrillation (AF). METHODS Plasma BNP levels were measured and TEE (transesophageal echocardiography) and CT/MRI were performed in 103 consecutive patients with lone AF. Fifteen patients with a history of thromboembolism or echocardiographic evidence of thrombus were compared with 88 AF patients without complications. Sixteen AF patients with failed cardioversion or recurrence of AF were compared with seven patients with successful cardioversion and maintenance of sinus rhythm. RESULTS The patients with thromboembolism had higher plasma BNP levels than the patients without thromboembolism ［(150±43) ng/L vs (84±40 )ng/L, P<0.05］. The patients of failed cardioversion had higher plasma BNP levels, longer duration of AF and greater left atrial diameter（LAD) than the patients of successful cardioversion ［(178±70)ng/L versus(60±32)ng/L, (8±3)m versus (3±2)m, ( 49±5)mm versus (42±3) mm, respectively. All P<0.05］. Overall analysis of the continuous variables with multiple logistic regression analysis revealed that BNP was a significant predictor of thromboembolism (P<0.05). BNP, LAD and history of AF were independent predictors of failed cardioversion and the recurrence of AF (all P<0.05). CONCLUSION BNP levels can be used as a useful noninvasive measure to detect patients at high risk thromboembolism and select the patients who should undergo cardioversion for lone AF.

参考文献/References

［1］ Inoue S ,Murakami Y,Sano K,et al. Atrium as a source of brain natriuretic polypeptide in patients with atrial fibrillation［J］. J Card Fail ,2000 ,6(2) :92-96.

［2］ Ohta Y, Shimada T, Yoshitomi H, et al. Drop in plasma brain natriuretic peptide levels after successful direct current cardioversion in chronic atrial fibrillation ［J］. Can J Cardiol, 2001，17（4）: 415-420.

［3］ Wilkins MR, Redondo J, Brown LA. The natriuretic peptide family［J］. Lancet, 1997, 349（9061）:1307-1310.

［4］ Fatkin D,Kelly RP,Feneley MP.Relation between left atrial appendage blood flow velocity,spontaneous echocardiographic contrast and thromboembolic risk in vivo［J］. J Am Coll Cardiol,1994,23（4）:961-969.

［5］ Shimizu H, Murakami Y, Inoue S,et al. High plasma brain natriuretic polypeptide level as a marker of risk for thromboembolism in patients with nonvalvular atrial fibrillation［J］ . Stroke，2002 ，33(4):1005-1010.

［6］ Raitt MH, Volgman AS, Zoble RG, et al. Prediction of the recurrence of atrial fibrillation after cardioversion in the Atrial Fibrillation Followup Investigation of Rhythm Management (AFFIRM) study［J］. Am Heart J, 2006,151（2）：390-396.

［7］ BeckdaSilva L, de Bold A, Fraser M,et al. Brain natriuretic peptide predicts successful cardioversion in patients with atrial fibrillation and maintenance of sinus rhythm ［J］. Can J Cardiol，2004 ，20(12):1245-1248.

［8］ Lellouche N, Berthier R, MekontsoDessap A, et al. Usefulness of plasma Btype natriuretic peptide in predicting recurrence of atrial fibrillation one year after external cardioversion ［J］. Am J Cardiol，2005，95(11):1380-1382.

备注/Memo

备注/Memo:
收稿日期：2006-05-23.作者简介：肖春晖,主治医师,硕士Email: feifei19701021@yahoo.com
更新日期/Last Update: