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| Clinical Value of Plasma NT-proBNP Combined with Electrocardiogram in Predicting Pulmonary Hypertension Associated with Congenital Heart Disease |
| ZHAO Na |
| Shangcai Caizhou Hospital,Zhumadian Henan 463899 |
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Abstract 【Objective】To study the clinical value of plasma N-terminal pro brain natriuretic peptide (NT-proBNP) combined with electrocardiogram (ECG) in predicting pulmonary hypertension (PAH) associated with congenital heart disease (CHD). 【Methods】Sixty-two patients with simple CHD in our hospital from February 2018 to February 2021 were selected as the CHD group, and 53 patients with both CHD and PAH in the same period were selected as the CHD-PAH group. The general data of all patients were counted, the plasma NT-proBNP level was detected, and the ECG was detected. The general data, plasma NT-proBNP level and ECG parameters were compared between the two groups. The influencing factors of CHD complicated with PAH were analyzed by logistic regression; Receiver operating characteristic (ROC) was used to evaluate the predictive value of plasma NT-proBNP combined with ECG for CHD complicated with PAH. 【Results】There were no significant differences in sex, age, BMI, HR, SBP, DBP and defect type between the two groups (P>0.05). The proportion of pulmonary systolic pressure and NYHA class Ⅲ ~ Ⅳ in the CHD-PAH group was higher than that in the CHD group, and the 6-minute walking distance (6MWD) in the CHD-PAH group was shorter than that in the CHD group (P<0.05). The plasma NT-proBNP level, QTc interval and RV5 amplitude in the CHD-PAH group were higher than those in the CHD group (P<0.05). Logistic regression analysis showed that pulmonary artery systolic pressure, NYHA cardiac function grade, 6min walking distance, plasma NT-proBNP level, QTc interval and RV5 amplitude were the influencing factors of CHD complicated with PAH (P<0.05). The ROC analysis showed that the cut off values of NT-proBNP, QTc interval and RV5 amplitude predicted CHD combined with PAH were 712.68 ng/L, 418.59 ms and 2.09 mv, respectively, and their AUC values were 0.883, 0.875 and 0.848, respectively. And the AUC value of joint detection (NT-proBNP combined with ECG) was 0.957. 【Conclusion】Plasma NT-proBNP combined with ECG has certain predictive value for CHD complicated with PAH, which has certain clinical significance.
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Received: 15 February 2024
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[1] SCOTT M, NEAL A E. Congenital heart disease[J].Prim Care,2021,48(3):351-366.
[2] VONK M C, VANDECASTEELE E, VAN DIJK A P. Pulmonary hypertension in connective tissue diseases, new evidence and challenges[J].Eur J Clin Invest,2021,51(4):e13453.
[3] 徐茁原,张红胜,李强强,等.先天性心脏病相关肺动脉高压复合临床恶化事件的初步研究[J].中华心血管病杂志,2022,50(3):282-288.
[4] REYNEN S, SCHLOSSBAUER M, HUBAUER U, et al. Urinary N-terminal pro-brain natriuretic peptide: prognostic value in patients with acute chest pain[J].ESC Heart Fail,2021,8(3):2293-2305.
[5] GARCÓA LLEDÓ A. The electrocardiogram in pulmonary hypertension: Scanning for an Iceberg[J].Arch Bronconeumol (Engl Ed),2021,57(5):319-320.
[6] 国家卫生健康委员会国家结构性心脏病介入质量控制中心,国家心血管病中心结构性心脏病介入质量控制中心,中华医学会心血管病学分会先心病经皮介入治疗指南工作组,等. 常见先天性心脏病经皮介入治疗指南(2021版)[J].中华医学杂志,2021,101(38):3054-3076.
[7] 中华医学会呼吸病学分会肺栓塞与肺血管病学组,中国医师协会呼吸医师分会肺栓塞与肺血管病工作委员会,全国肺栓塞与肺血管病防治协作组,等. 中国肺动脉高压诊断与治疗指南(2021版)[J].中华医学杂志,2021,101(1):11-51.
[8] 张雅芝,彭华,刘亚兰,等.新生儿持续性肺动脉高压与先天性心脏病相关肺动脉高压导致心脏损伤的比较研究[J].临床心血管病杂志,2021,37(6):561-563.
[9] AHMED A M, MOHAMED N A E, ABDELHAMID E M, et al.N-terminal pro-brain natriuretic peptide as a biomarker for differentiating cardiac and pulmonary disease in term neonates with respiratory distress[J].J Saudi Heart Assoc,2020,32(1):65-70.
[10] 马爱闻,徐继扬,陈俊,等.N末端B型钠尿肽原及心肌肌钙蛋白I对慢性阻塞性肺疾病合并肺动脉高压患者病情的评估价值[J].实用临床医药杂志,2020,24(7):16-19.
[11] COLOM G, SALVADOR J P, ACOSTA G, et al. Competitive ELISA for N-terminal pro-brain natriuretic peptide (NT-proBNP) determination in human plasma[J].Analyst,2020,145(20):6719-6727.
[12] 付冰峰,陶旭炜.血清BNP、VEGF、TGF-β1与新生儿持续性肺动脉高压病情严重程度的相关性及对预后的评估价值[J].中国现代医学杂志,2021,31(3):59-64.
[13] 张苏明,陈慧,郭冠军,等.计算法合成右侧胸部心电图导联对肺动脉高压的检测和评价[J].心血管康复医学杂志,2021,30(2):199-203.
[14] PIŁKA M, MAѝCZAK M, DAROCHA S, et al. Assessment of Clinical Usefulness of Resting Electrocardiogram (PH-ECG Score) in Monitoring the Efficacy of Balloon Pulmonary Angioplasty (BPA) in Patients with Chronic Thromboembolic Pulmonary Hypertension (CTEPH)[J].J Clin Med,2021,10(19):4548.
[15] 龚帆影,周晶晶,刘福明.心电图对特发性肺动脉高压治疗及预后的应用价值[J].海南医学院学报,2019,25(19):1507-1511.
[16] 邬晓臣,岳琴,王舰,等.高原先天性心脏病并发肺动脉高压患儿的围手术期心电图变化的意义[J].心脏杂志,2021,33(1):36-38.
[17] 梅帆,聂钰君.先心病肺动脉高压患儿心电图P波、QRS波特征与生存质量的关系[J].中国数字医学,2019,14(9):45-46. |
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