H<sub>2</sub>FPEF评分、NT-proBNP联合LVDF在射血分数保留的2型糖尿病患者DCM危险程度中的评估价值

doi:10.3969/j.issn.1671-7171.2023.05.006

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Abstract 【Objective】 To investigate the effects of H₂FPEF score, N-terminal B-type natriuretic peptide precursor (NT-proBNP) combined with left ventricular diastolic function (LVDF) on the evaluation value of risk degree of diabetes cardiomyopathy (DCM) in patients with type 2 diabetes (T2DM) with ejection fraction (EF) preserved. 【Methods】 A retrospective analysis was conducted on the clinical data of 593 T2DM patients with EF ≥ 50% who were treated at the Shenzhen Second People's Hospital from February 2014 to April 2019. Using H₂FPEF score, NT-proBNP and LVDF as key indicators ,the cluster analysis was first used to classify the DCM risk level of the study population and obtain the DCM risk staging; Then Fisher discriminant analysis on the above stages was perform to obtain a method for determining the risk stage of DCM. 【Results】Through cluster analysis, the study subjects were divided into four phases of DCM risk: the Phase 1 was a low-risk stage of DCM, with 98 cases (16.52%) having a low H₂FPEF score of (0.52 ± 0.50), an NT-proBNP score of (38.98 ± 24.80) pg/mL, and a normal LVDF; the Phase 2 was a moderate risk stage for DCM, with 469 cases (79.09%) having a low H₂FPEF score of (1.47 ± 0.92), normal NT-proBNP [(61.79 ± 54.22) pg/mL], and reduced LVDF; the Phase 3 was a high-risk period for DCM, with 17 cases (2.87%) having a low H₂FPEF score of (1.53 ± 1.18), an increase in NT-proBNP[(344.18 ± 106.94) pg/mL], and a decrease in LVDF; the Phase 4 was a very high-risk period, with 9 cases (1.52%), with an H₂FPEF score of (2.89 ± 1.17), an increase in NT-proBNP [(550.44±153.87) pg/mL] and a decrease in LVDF. Four Bayesian discriminant functions were obtained through Fisher discriminant analysis on the above four periods, with accuracy rates greater than 90%. This discriminant function could be used to determine the DCM risk staging for T2DM patients with EF ≥ 50%. 【Conclusions】The H₂FPEF score, NT-proBNP combined with LVDF provide a new method for evaluating the risk of DCM in T2DM patients with EF preservation.

Key words： Diabetes Mellitus, Type 2 Cardiomyopathy, Dilated Natriuretic Peptide, Brain/BL Cardiac Output

Received: 06 October 2022

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R587.23

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2023.05.006 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2023/V40/I5/659

[1] BOUDINA S, ABEL E D. Diabetic cardiomyopathy revisited[J].Circulation,2007,115(25):3213-3223.
[2] LITWIN S E. Diabetes and the heart: is there objective evidence of a human diabetic cardiomyopathy? [J].Diabetes,2013,62(10):3329-3330.
[3] 中华医学会心血管病学分会心力衰竭学组,中国医师协会心力衰竭专业委员会,中华心血管病杂志编辑委员会.中国心力衰竭诊断和治疗指南2018[J].中华心血管病杂志,2018,46(10):760-789.
[4] REDDY Y, CARTER R E, OBOKATA M, et al. A simple, evidence-based approach to help guide diagnosis of heart failure with preserved ejection fraction [J]. Circulation ,2018,138(9):861-870.
[5] JANUZZI J L, VAN KIMMENADE R, LAINCHBURY J, et al. NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: an international pooled analysis of 1256 patients: the international collaborative of NT-proBNP study [J].Eur Heart J,2006,27(3):330-337.
[6] AMERICAN DIABETES ASSOCIATION. Microvascular complications and foot care: standards of medical care in diabetes-2020 [J].Diabetes Care,2020,43(Suppl 1):S135-S151.
[7] GARGIULO P, MARSICO F, RENGA F, et al. The metabolic syndrome in heart failure: insights to specific mechanisms [J].Heart Fail Rev,2020,25(1):1-7.
[8] MAISCH B, ALTER P, PANKUWEIT S. Diabetic cardiomyopathy-fact or fiction[J].Herz,2011,36(2):102-115.
[9] SEFEROVIC＇ P M, PETRIE M C, FILIPPATOS G S, et al.Type 2 diabetes mellitus and heart failure: a position statement from the Heart Failure Association of the European Society of Cardiology [J].Eur J Heart Fail,2018,20(5):853-872.
[10] BRAUNWALD E. Biomarkers in heart failure[J].N Engl J Med,2008,358(20):2148-2159.
[11] BORLAUG B A, PAULUS W J. Heart failure with preserved ejection fraction: pathophysiology, diagnosis and treatment [J].Eur Heart J,2011,32(6):670-679.
[12] SEFEROVIC＇ P M, PAULUS W J. Clinical diabetic cardiomyopathy: a two-faced disease with restrictive and dilated phenotypes [J].Eur Heart J,2015,36(27):1718-1727.