Correlation Study Between Blood Level of Big Endothelin-1 and Cardiac Remodeling in Patients With Hypertrophic Obstructive Cardiomyopathy / 中国循环杂志

Objective:To explore the relationship between big endothelin-1 (big ET-1) and cardiac remodeling in patients with hypertrophic obstructive cardiomyopathy (HOCM). Methods:A total of 167 consecutive HOCM patients admitted in our hospital from 2015-01 to 2016-05 were enrolled. Blood levels of big ET-1 and NT-proBNP were measured;electrocardiogram(ECG), dynamicECG,echocardiography (UCG) and cardiovascular magnetic resonance (CMR) were examined for relevant statistical analysis. Results:In all 167 HOCM patients, blood level of Big ET-1 was positively related to NT pro-BNP (r=0.35, P=0.000), left atrial (LA) diameter (r=0.169, P=0.019) and heart rate (r=0.141, P=0.037);negatively related to hemoglobin (r=-0.173, P=0.013) and the ratio of interventricular septum (IVS)/posterior wall of left ventricle (r=-0.165, P=0.017). Based on the finding of positive correlation between Big ET-1 and LA diameter, the patients were divided into 2 groups:Normal LA group, n=74 and Enlarged LA group, n=93. Compared with Normal LA group,Enlarged LA group had the higher blood level of Big ET-1 (P=0.001);increased left ventricular end-diastolic diameter (LVEDD) (P=0.024), thicker IVS (P=0.003), lower LVEF (P=0.001);enlarged LVED volume (P=0.002) and IVS (P=0.002);elevated ratio of atrial fibrillation(AF);more patients with moderate to severe mitral regurgitation (MR) and NYHA functional classIII/IV. Conclusion: Blood level of Big ET-1 was positively related to NT pro-BNP and LA diameter in HOCM patients;the patients with enlarged LA had increased Big ET-1, more obvious cardiac remodeling and the higher incidence of AF occurrence which implied that Big ET-1 might play the role in cardiac remodeling in HOCM patients.

Application of Child-Turcotte-Pugh Scores in Predicting the Risk of Death for In-hospital Heart Failure Patients / 中国循环杂志

Objective: Heart failure (HF) patients are usually associated with liver function impairment, Child-Turcotte-Pugh (CTP) scores can evaluate liver function, but its effect in HF patients has been unclear. We want to study the application of CTP scores in predicting the risk of death for in-hospital HF patients. Methods: A total of 1180 consecutive in-hospital HF patients were enrolled. According to CTP scores evaluated liver function at admission, the patients were divided into 3 groups: CTP grade A group, n=951, CTP grade B group, n=206 and CTP grade C group, n=23. The endpoint of this study was all-cause death. Results: There were 180 patients died at 1 year follow-up period, the in-hospital and 1 year mortalities were increased with the elevated CTP grades accordingly: for in-hospital mortalities in CTP grade A, B and C groups were (0.8%, 11.7% and 56.5%) respectively, P Conclusion: CTP scores may independently predict the risk of death for in-hospital HF patients, the levels of CTP scores might be used for evaluating the efficacy of in-hospital treatment.

Prevalence and prognostic value of hyponatremia on admission in hospitalized patients with heart failure / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the prevalence and prognostic value of hyponatremia on admission in hospitalized patients for heart failure (HF) from the first HF management center in China.</p><p><b>METHODS</b>Consecutive adult (age of 18 years or older) symptomatic HF patients (NYHA functional class II-IV) admitted between March 2009 and March 2012 in our center were included in the present analysis. Hyponatremia was defined as a serum sodium level < 135 mmol/L. Association between hyponatremia on admission and in-hospital mortality as well as all-cause death and heart failure death during 1-year follow-up after discharge was analyzed.</p><p><b>RESULTS</b>A total of 1 048 hospitalized patients for HF with complete baseline data were enrolled and the prevalence of hyponatremia on admission was 9.2% (96/1 048). Blood pressure was significantly lower while NYHA functional class and N-terminal pro-B type natriuretic peptide levels were significantly higher in hyponatremic patients than non-hyponatremic patients (all P < 0.05). Kaplan-Meier survival analysis showed that patients with hyponatremia on admission had significant higher in-hospital mortality (P < 0.01), all-cause death rate (P < 0.01) and HF death rate (P < 0.01) during 1-year follow-up post discharge compared with non-hyponatremic patients with. Multiple Cox proportional hazard analysis showed that hyponatremia on admission remained as independent predictor for all-cause death (hazard risk (HR) = 2.105, 95% confidence interval (CI) 1.460-3.036, P < 0.01) and HF death (HR = 2.458, 95% CI: 1.704-3.545, P < 0.01) after adjustment for other covariates.</p><p><b>CONCLUSION</b>Hyponatremia is relatively common in patients hospitalized with HF in China and hyponatremia on admission is associated with higher in-hospital mortality and all-cause death and HF death one year after discharge.</p>

Reference value and clinical correlates of soluble ST2 in healthy community-based Chinese population / 中华心血管病杂志

<p><b>OBJECTIVE</b>This study was designed to investigate the plasma level of soluble ST2 (sST2) and related influencing factors, and establish its reference value in the healthy community-based population in Beijing area of China.</p><p><b>METHODS</b>We measured plasma sST2 level by enzyme-linked immunosorbent assay between March 2012 and August 2012 in 1 334 healthy subjects in communities, including 597 males and 737 females. Empiric and quantile regression methods were used to determine the reference range of plasma sST2. A multiple linear regression model was established to analyze the factors that might affect the level of plasma sST2.</p><p><b>RESULTS</b>Gender is the most important factor affecting the plasma level of sST2 in healthy people. Plasma level of sST2 is significantly higher in men than in women (P < 0.01). Within each age strata, i.e. < 45, 45-54, 55-64, ≥ 65 years old, the plasma levels of sST2 were significantly higher in men than age-matched female (all P < 0.01). Age, body mass index (BMI), systolic blood pressure, diastolic blood pressure, and smoking did not affect plasma sST2 level. Reference range of sST2 was 5.7-53.5 µg/L for men and 4.4-42.4 µg/L for women (95% nonparametric reference interval). The one-side upper 95th percentile value of sST2 to discriminate the cardiovascular disease from healthy state was 47.2 µg/L for men and 37.2 µg/L for women.</p><p><b>CONCLUSIONS</b>This study established the normal reference range of plasma sST2 in healthy community-based population. The major influencing factor of sST2 level in healthy population is gender.</p>

Plasma amino-terminal pro-brain natriuretic peptide level and affecting factors in a community-based healthy Chinese population / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the plasma level of amino-terminal pro-brain natriuretic peptide (NT-proBNP) and related influencing factors in a community-based healthy population in Beijing area.</p><p><b>METHODS</b>We measured plasma NT-proBNP level by fluoroimmunoassay between March 2012 and July 2012 from 1 034 healthy subjects (including 486 men and 548 women). Empiric method was used to determine the reference value and influencing factors were analyzed.</p><p><b>RESULTS</b>Age and gender are important factors affecting the level of NT-proBNP in healthy subjects. NT-proBNP plasma level is significantly higher in women than in men within each age strata below 75 years old, i.e. < 45, 45-54, 55-64 and 65-74 years old (P = 0.005, 0.001, 0.001, 0.011 respectively), but NT-proBNP plasma level is similar between male and female older than 75 years (P = 0.504). NT-proBNP level also increases with age irrespective of gender. Body mass index (BMI) is another independent influencing factor of NT-proBNP (P < 0.001), while estimated glomerular filtration rate is not influencing factor. The reference range of NT-proBNP is < 133 ng/L for men and < 289 ng/L for women aged < 55 years old, < 185 ng/L for men and < 333 ng/L for women aged between 55 and 64 years old, and < 465 ng/L for men and < 378 ng/L for women aged ≥ 75 years old.</p><p><b>CONCLUSION</b>The major influencing factors of NT-proBNP level in the healthy population are age, gender and BMI. It essential to establish normal reference range of NT-proBNP according to these factors for Chinese population.</p>

Predict value of soluble ST2 on one-year mortality for hospitalized patients with chronic heart failure / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the predict value of plasma soluble ST2 (sST2) on one-year mortality for hospitalized patients with chronic heart failure (HF).</p><p><b>METHODS</b>A total of 1 244 consecutive hospitalized patients admitted to Heart Failure Center Fuwai Hospital between March 2009 and July 2012 and with HF as their primary diagnosis were included. Plasma sST2 was measured in all patients and patients were followed up for 1 year, and the primary endpoint was defined as all-cause death.</p><p><b>RESULTS</b>There were 193 deaths during follow up. sST2 concentrations at admission were positively correlated with NT-proBNP, NYHA functional class and heart rate, and negatively correlated with left ventricular ejection fraction, blood sodium, total cholesterol and glomerular filtration rate at admission. sST2 concentrations were significantly higher in non-survivors compared with survivors (P < 0.001). Multivariable Cox regression analyses showed that sST2 independently predicted 1-year mortality (per 1 log unit, hazard ratio 1.87, 95% confidence interval: 1.56 to 2.25, P < 0.001). In receiver operating characteristic analyses, the area under the curve for ST2 was 0.776 which was similar to that of N-terminal pro-B-type natriuretic peptide (NT-proBNP) (AUC = 0.775). The prognostic value was improved when combining these two biomarkers together (AUC = 0.813).</p><p><b>CONCLUSIONS</b>sST2 concentration at admission is correlated with clinical and biochemical indexes and associated with 1-year mortality for hospitalized patients with HF.</p>