- 作者：Christian Alcaraz Frederiksen ; MD?/sup> ; &dagger ; ; caf@ki.au.dk ; Peter Juhl-Olsen ; MD?/sup> ; &dagger ; ; Carl-Johan Jakobsen ; MD?/sup> ; &dagger ; ; Erik Sloth ; MD ; PhD ; DMSc?/sup> ; &dagger ;
- 关键词：echocardiography ; preoperative ; cardiac anesthesia ; cardiac function ; speckle tracking ultrasound ; Doppler ; strain ; N-terminal probrain natriuretic peptide
- 刊名：Journal of Cardiothoracic and Vascular Anesthesia
- 出版年：2012
- 出版时间：April, 2012
- 年：2012
- 卷：26
- 期：2
- 页码：197-203
- 全文大小：1219 K
Objective
The authors hypothesized that preoperative N-terminal probrain natriuretic peptide (NT-proBNP) correlates well with longitudinal strain measurements and with Doppler measurements of diastolic function.Design
Prospective observational study.
Setting
University teaching hospital.
Participants
Forty patients undergoing elective cardiac surgery.
Interventions
Aortic valve replacement, coronary artery bypass grafting, or a combination of these procedures.
Measurements and Main Results
Plasma NT-proBNP concentration was obtained by analyzing blood samples with a commercially available kit. Left ventricular systolic function was assessed by speckle tracking ultrasound strain measurements and left ventricular diastolic function was assessed by 2 Doppler methods: E/A ratio and E/E?ratio. Tissue Doppler imaging velocities (E?and A? were measured in the basal septum (annular) and pulse-wave Doppler was used to measure mitral in-flow profile (E and A). The correlation between global strain data from the speckle tracking ultrasound measurement and NT-proBNP levels was ¦Ñ = 0.35 (p = 0.026). With a cutoff value of ?5 % in global strain measurements, there was a significant difference in NT-proBNP levels (117 v 57 pg/mL, p = 0.048). E/E?values correlated with NT-proBNP levels (¦Ñ = 0.46, p = 0.011). With a cutoff of 15 in E/E?values, there were significant differences in corresponding NT-proBNP levels (33 v 113 pg/mL, p = 0.004).
Conclusions
A correlation was found between plasma levels of NT-proBNP and speckle tracking ultrasound strain measurements by an easily employed method applicable in the anesthesia and preoperative settings. In addition, the well-established marker of diastolic function, E/E? correlated well with NT-proBNP, whereas the E/A ratio failed to show any association.