Influence of acute hyperglycemia on the assessment of cardiac function with N-terminal pro-brain natriuretic peptide / 中华急诊医学杂志

ABSTRACT

Objective To investigate the relationship between N-terminal pro-brain natriuretic peptide (NT-proBNP) and tissue Doppler imaging (TDI) derived cardiac function index (Tei index) in patients with acute coronary syndrome under different plasma glucose levels and to evaluate the influence of hyperglycemia on the preciseness of cardiac function assessment with NT-proBNP.Methods Consecutive patients with acute coronary syndrome admitted to the department of cardiology in Guangdong General Hospital were prospectively enrolled.Based on their plasma fasting glucose level,patients were divided into hyperglycemia group (fasting plasma glucose ≥ 6.1 mmol/L) and euglycemia group (fasting plasma glucose ＜ 6.1 mmol/L).All the patients underwent transthoracic echocardiagraphy and tissue Doppler imaging (TDI) investigations.Blood samples were obtained within 24 hours of hospitalization for measurment of NT-proBNP level.Relationship between TDI-Tei index and the level of NT-proBNP in the two groups were analyzed respectively.Results The TDI-Tei index,the systolic index and the diastolic index were all significant higher in the hyperglycemia group (n =27) than those in the euglycemia group (n =35)(0.68±0.14) vs.(0.61 ±0.10),P =0.03; (0.29±0.07) vs.(0.26±0.05),P =0.045; (0.38±0.08) vs.(0.35 ±0.050,P =0.03,respectively.In both groups,TDI-Tei and In NT-proBNP showed significant linear regression.In the hyperglycemia group,TDI-Tei =0.175 + 0.068 In NT-proBNP,R2 =0.702,P ＜ 0.01.In the euglycemia group,TDI-Tei =0.185 + 0.060 In NT-proBNP,R2 =0.405,P ＜ 0.01.Conclusions (1) Compared with patients suffering from an acute coronary syndrome with euglycemia,the global cardiac function of patients with hyperglycemia is poorer; (2) NT-proBNP correlates significantly with TDI-Tei in both hyperglycemia and euglycemia patients with acute heart syndrome.It is appropriate to assess global cardiac function with NT-proBNP in patients suffering from ACS complicated with hyperglycemia.