血浆B型利钠肽与肥厚型梗阻性心肌病患者发生心房颤动的关系

Relationship Between Plasma Level of BNP and Atrial Fibrillation Occurrence in Patients With Obstructive Hypertrophic Cardiomyopathy

目的:探讨血浆B型利钠肽(BNP)与肥厚型梗阻性心肌病患者发生心房颤动的关系。方法:连续入选166例因肥厚型梗阻性心肌病在我院行改良扩大Morrow术的患者,记录一般临床资料,超声心动图资料,测量血浆BNP浓度,将患者分为心房颤动组(n=26)和非心房颤动组(n=140),比较两组患者血浆BNP浓度差别,分析BNP与心房颤动相关性。结果:与非心房颤动组相比,心房颤动组左心房内径较大[(46.2±9.1)mm vs(41.2±6.8)mm,P<0.05],左心室射血分数较低[(70.5±9.7)%vs(73.9±6.9)%,P<0.01],差异均有统计学意义。心房颤动组LogB NP水平高于非心房颤动组,差异有统计学意义(P<0.001)。多因素回归分析显示LogB NP是肥厚型梗阻性心肌病患者心房颤动发生的独立危险因素(P<0.001)。结论:血浆BNP水平是肥厚型梗阻性心肌病患者心房颤动发生的独立危险因素。

Objective： To explore the relationship between plasma level of B-type natriuretic peptide （BNP） and atrial ifbrillation （AF） occurrence in patients with obstructive hypertrophic cardiomyopathy （HOCM）. Methods： A total of 166 consecutive HOCM patients treated by modified Morrow operation in our hospital were studied. The patients were classified into 2 groups： AF group, n-26 and Non-AF group, n-140. The basic clinical information and echocardiography measurement were recorded, plasma level of BNP was examined and compared between 2 groups. Results： Compared with Non-AF group, AF group showed the increased left atrial diameter as （46.2 ±9.1） mm vs （41.2 ±6.8） mm, P〈0.05 and decreased left ventricular ejection fraction （LVEF） as （70.5 ±9.7） % vs （73.9 ±6.9） %, P〈0.01. The LogBNP value was higher in AF group than that in Non-AF group, P〈0.001. Multivariate regression analysis indicated that LogBNP value was the independent risk factor for AF occurrence in HOCM patients, P〈0.001. Conclusion： Plasma level of BNP is the independent risk factor for AF occurrence in HOCM patients.