Values of BNP,IL-6 and IL-10 in Stratification and Prognostic for Patients with Congestvie Heart Failure / 天津医药

ABSTRACT

Objective:To investigate the changes of left ventricular mass index(LVMI),plasma brain natriuretic peptide (BNP),interJeukin-6(IL-6)and interleukin-10(IL-10)in patients with congestive heart failure(CHF),and their values in risk stratification and prognostic evaluation of CHF thereof.Methods:Ninety-five patients with CHF in accordance with 2001ACC/AHA guidelines were enrolled and stratified as stage A(n=21),B(n=23),C(n=31)and D(n=20).The levels of plasma BNP,IL-6 and IL-10 were measured and compaired with those in 20 healthy subjects(control group).The patients were followed up every three months in two years.The end point was the rehospitalization and the cardiac death.Results:(1)The level of LVMI increased early in patients with CHF at stage B.(2)The plasma BNP levels were initially elevated in CHF patients at stage B,and the concentrations of BNP closely paralleled disease severity.(3)The levels of plasma IL-6 and IL-10 were increased,and the ratio of IL-10/IL-6 was decreased,with the progression of CHF at stage C and D.The plasma BNP level was positively correlated with the levels of IL-6 and IL-10.(4)The new CHF stratification was surperior to NYHA functional classification in regard to CHF prognosis prediction.(5)Multivariate COX regression analysis showed the levels of BNP and IL-6 were the independent risk factors in prognostic evaluation(P＜0.01,P=0.026).(6)Patients in high-risk groups stratified by the combination of BNP and stage classification had obviously higher end point events rate.Conclusion:(1)LVMI was a better marker for the evaluation of left ventrieular remodeling.(2)The intrinsic mechanism of CHF progression was inflammatory reaction deterioration.(3)BNP was a good marker in predicting onset and prognosis of CHF.The combination of BNP and the stage classification could improve the prognostic evaluation in patients with CHF.