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>

Cognitive function and factors related to cognitive function in hospitalized patients with chronic heart failure / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the cognitive function status and potential influence factors on cognitive function in hospitalized patients with chronic heart failure.</p><p><b>METHODS</b>Using a cross-sectional research design, CHF patients (n = 267, mean age (63.8 ± 9.4) years) were recruited from two care units-Heart Failure Care Unit and Intensive Care Unit of our hospital. Cognitive function status was evaluated by the Montreal Cognitive Assessment (MoCA) screen test.</p><p><b>RESULTS</b>Based on the MoCA score, 37.8% (101/267) patients suffered from cognitive impairment (score<26), especially on the three specific cognitive functions-memory, langue and executive capability. Multifactorial analysis showed that after controlling for other factors, there was a downward trend on cognitive function with aging (OR = 1.09, 95%CI:1.05-1.14) while higher left ventricular ejection fraction (LVEF) was related to better cognitive function (OR = 0.97, 95%CI:0.95-0.99); patients who took medicine regularly also had better cognitive function (OR = 3.71, 95%CI:1.40-10.91); cognitive function was better in patients with high level of social support compared those with low social support (OR = 0.92, 95%CI:0.88-0.96).</p><p><b>CONCLUSIONS</b>Incidence of cognitive impairment is high in hospitalized patients with chronic heart failure. Age, LVEF, whether taking medication regularly and social support are factors related to cognitive function in CHF patients.</p>