Relationship of B-type natriuretic peptide, C-reactive protein and left ventricular diastolic function with cardio-and cerebrovascular disease in the elderly patients with hemodialysis / 中华老年医学杂志

ABSTRACT

Objective To investigate the relationship of B-type natriuretic peptide(BNP),Creactive protein(CRP)and left ventricular diastolic function with cardio-and cerebrovascular disease (CVD)in the elderly patients with hemodialysis.Methods 96 elderly patients with hemodialysis were divided into CVD group(n =35)and non CVD control group(n =61).The patients were followed up once a month for 24 to 30 months.The baseline anthropometric and laboratory parameters were measured.The ratio of mitral peak flow velocity(E)and peak velocities at mitral annuluses (Em)during early diastole of left ventricular was recorded by doppler echocardiography.The time and cause of hospitalization and mortality by CVD were documented.Results The levels of CRP and BNP were significantly higher in CVD group than in control group[(3.1 ± 6.7)mg/L vs.(1.8 ± 1.2)mg/L,(1345.2±1427.8)pmol/L vs.(719.8±1073.8)pmol/L](t=2.14 and-2.82,P＜0.05 or P＜0.01).The ratio of E/ Em was increased in CVD group as compared with control group(t=5.23,P＜0.01).Kaplan-Meier survival curves showed that the morbidity of CVD events was enhanced(P＜0.05 or P＜0.01)at BNP≥500 pmol/L,CRP≥1.5 mg/L and E/Em≥17 which were the independent risk factors of CVD events for the elderly patients with hemodialysis by COX regression model.There was positive correlation between LogBNP and E /Em(r =0.23,P ＜ 0.05).Conclusions Higher levels of BNP,CRP and E/Em may predict the increasing risks of CVD in the elderly patients with hemodialysis.