Clinical value of plasma NT－proBNP and left ventricular mass index in the diagnosis of elderly patients with normal left ventricular ejection fraction / 中国基层医药

ABSTRACT

Objective To investigate the clinical value of plasma NT －proBNP and left ventricular mass index in the diagnosis of heart failure (HF) with normal left ventricular ejection fraction (LVEF) in elderly patients. Methods From August 2014 to August 2017,82 patients with congestive heart failure in the People's Hospital of Yinzhou were enrolled .According to the results of LVEF in echocardiography ,the patients were divided into HFNEF group (41 cases) and HFREF group (41 cases),another 40 patients with normal heart function were selected as the control group.The relative indicators of echocardiography were compared among the three groups .The plasma NT－proBNP levels were compared among the three groups .The ROC curve of plasma NT －proBNP was used to diagnose HFNEF,and the sensitivity and specificity of HFNEF were calculated .The ROC curve of left ventricular mass index (LVMI)was drawn and its sensitivity and specificity were calculated .The plasma NT－proBNP level was used as an indirect indicator of left ventricular filling pressure ,the correlation of LVMI and plasma NT －proBNP in the HFNEF group was compared .Results The LVMI in the control group was significantly lower than that in the HF group [(86.95 ±8.72)g/m2vs.(130.53 ±15.18)g/m2,t ＝20.078,P＝0.000),but there was no statistically significant difference between the HFNEF group and HFREF group (P＞0.05).The NT－proBNP was the lowest in the control group,followed by the HFNEF group and HFREF group ,the difference was statistically significant among the three groups [(72.56 ±7.81)ng/mL vs.(182.55 ±18.45)ng/mL vs.(653.58 ±55.95)ng/mL,F＝8.254, P＝0.000).The sensitivity,specificity,positive predictive value and negative predictive value of HFNEF were 0.94, 0.83,0.95 and 0.21,respectively,when NT－proBNP 131pg/mL was used as the cut －off value.The sensitivity and specificity of HFNEF were 0.62 and 0.99,respectively,when LVMI＞125 g/m2was used as the standard .The corre－lation between plasma NT－proBNP and LVMI in the HFNEF group was r＝0.513 (P＜0.01).Conclusion Plasma NT－proBNP and LVMI in elderly patients with HFNEF are significantly higher than those in elderly patients with HFNEF,which may be useful for the diagnosis of HFNEF ,independent use of NT －proBNP or LVMI for diagnosis , there may be some defects ; if applied together,may improve the accuracy of diagnosis .