老年心力衰竭患者血清MR-proANP与心肺运动试验参数的相关性

Correlation Between Serum MR-proANP and Parameters of Cardiopulmonary Exercise Test in Elderly Patients with Heart Failure

目的:分析老年心力衰竭患者血清中段心房利钠肽(MR-proANP)与心肺运动试验(CPET)参数的相关性。方法:回顾性分析2020年7月至2021年7月期间于郑州大学第五附属医院治疗的110例老年心力衰竭患者的病历资料,根据患者的纽约心脏病协会(NYHA)心功能分级结果将患者分为三组,分别为心功能Ⅱ级组40例;心功能Ⅲ级组40例;心功能Ⅳ级组30例。三组患者均进行血清MR-proANP水平检测和CPET检查。比较三组患者峰值摄氧量(PeakVO_(2))、二氧化碳通气当量斜率(VE/VCO_(2) slope)、峰值氧脉搏(VO_(2)/HR)、摄氧量与功率比值斜率(VO_(2)/WR slope)、无氧阈(AT)和血清MR-proANP水平,并分析血清MR-proANP与CPET参数的相关性。结果:与心功能Ⅱ级组比,心功能Ⅲ级组与心功能Ⅳ级组PeakVO_(2)、VO_(2)/HR、VO_(2)/WR slope和AT水平均更低,VE/VCO_(2) slope水平更高,差异均具有统计学意义(P<0.05);与心功能Ⅲ级组比,心功能Ⅳ级组PeakVO_(2)、VO_(2)/HR、VO_(2)/WR slope和AT水平更低,VE/VCO_(2) slope更高,差异均具有统计学意义(P<0.05);与心功能Ⅱ级组比,心功能Ⅲ级组和心功能Ⅳ级组MR-proANP水平均更高,差异均具有统计学意义(P<0.05);与心功能Ⅲ级组比,心功能Ⅳ级组MR-proANP水平更高,差异具有统计学意义(P<0.05);Spearman相关性分析显示,PeakVO_(2)、VO_(2)/HR、VO_(2)/WR slope、AT与MR-proANP呈负相关(P<0.05),VE/VCO_(2) slope与MR-proANP呈正相关(P<0.05),其中VE/VCO_(2) slope与MR-proANP相关性最高(r=0.638,P<0.05)。结论:老年心力衰竭患者血清MR-proANP水平与CPET检查参数中的PeakVO_(2)、VO_(2)/HR、VO_(2)/WR slope、AT水平呈负相关,与VE/VCO_(2) slope水平呈正相关。

Objective To analyze the correlation between plasma midregional pro-atrial natriuretic peptide(MR-proANP)and cardiopulmonary exercise test(CPET)parameters in elderly patients with heart failure.Methods The medical records of 110 elderly patients with heart failure who were treated in the Fifth Affiliated Hospital of Zhengzhou University from July 2020 to July 2021 were retrospectively analyzed.According to the heart function grading results of New York Heart association(NYHA),the patients were divided into three groups:40 patients with heart function grade Ⅱ group;40 patients with heart function grade Ⅲ group;30 patients with heart function grade Ⅳ group.Serum MR-proANP level and CPET were detected in the three groups.Peak oxygen uptake(PeakVO_(2)),equivalent slope of carbon dioxide ventilation(VE/VCO_(2) slope),peak oxygen pulse(VO_(2)/HR),slope of oxygen uptake to power ratio(VO_(2)/WR slope),anaerobic valve(AT)and serum MR-proANP levels of patients in the three groups were compared.The correlation between serum MR-proANP and CPET parameters was analyzed.Results Compared with heart function grade Ⅱ group,PeakVO_(2),VO_(2)/HR,VO_(2)/WR slope and AT levels were lower than those in heart function grade Ⅲ group and heart function grade Ⅳ group,while VE/VCO_(2) slope level was higher,the differences were statistically significant(P<0.05).Compared with heart function grade Ⅲ group,PeakVO_(2),VO_(2)/HR,VO_(2)/WR slope and AT levels in heart function grade Ⅳ group were lower,and VE/VCO_(2) slope was higher,the differences were statistically significant(P<0.05).MR-proANP levels were higher in grade Ⅲ and grade Ⅳ groups than those in grade Ⅱ group,and the differences were statistically significant(P<0.05).Compared with grade Ⅲ group,the level of MR-proANP in grade Ⅳ group was higher,and the difference was statistically significant(P<0.05).Spearman correlation analysis showed that PeakVO_(2),VO_(2)/HR,VO_(2)/WR slope and AT were negatively correlated with MR-proANP(P<0.05),while VE/VCO_(2) slope was positively correlated with MR-proANP(P<0.05).The correlation between VE/VCO_(2) slope and MR-proANP was the highest(R=0.638,P<0.05).Conclusion There was a negative correlation between serum MR-proANP and the levels of PeakVO_(2),VO_(2)/HR,VO_(2)/WR slope,AT in elderly patients with heart failure.And there was a positive correlation between serum MR-proANP and the level of VE/VCO_(2) slope in elderly patients with heart failure.