Predictive value of NT-proBNP level and IVC-CI on volume load and prognosis in patients with acute heart failure / 医学研究生学报

ABSTRACT

ObjectiveThe assessment of volume load status in patients with acute heart failure is of great significance for preventing volume overload. The aim of this study was to explore the predictive value of NT-proBNP level and IVC-CI on volume load and prognosis in patients with acute heart failure. MethodsFrom January 2017 to April 2019, the clinical characteristics of 98 patients with acute heart failure diagnosed and treated in the Peking University People's Hospital were retrospectively reviewed in this study. All of them were treated with routine anti-heart failure treatment. According to the level of relative volume balance, they were divided into volume overload group (65 cases) and non-volume overload group (33 cases). All the patients were followed up for 30 days after discharge. The patients with death and cardiogenic rehospitalization were included in the event group (30 cases), and the rest were in the non-event group (68 cases). NT-proBNP and IVC-CI in different volume load groups and different prognosis groups were compared. The volume index levels (serum albumin, hemoglobin, hematocrit, PCWP, CVP) of patients in different volume load groups were compared. The effects of NT-proBNP and IVC-CI on volume load and prognosis of patients were analyzed.ResultsThe levels of NT-proBNP [（1306.39±313.98）pg/mL], PCWP [（19.63±1.95）mmHg] and CVP [（14.65±1.03）cmHg] in the volume overload group were higher than those in the non-volume overload group, while the IVC-CI [（38.26±8.14）%], albumin [（16.23±2.12）g/L], hemoglobin and hematocrit [（36.26±2.78）%] in the volume overload group were lower than those in the non-volume overload group (P0.05). On discharge, the AUC of NT-proBNP, IVC-CI in predicting patients with acute heart failure was respectively 0.806 and 0.847. Although the prediction accuracy was relatively high, the AUC of combined prediction was 0.982, which was significantly higher than that of NT-proBNP and IVC-CI (Z=3.589, 3.274, both P<0.05).Conclusion There is a correlation between NT-proBNP, IVC-CI and volume indexes. The combined detection of NT-proBNP and IVC-CI can help to assess the volume load status of patients with acute heart failure and improve the predictive value of short-term prognosis of patients.