The diagnostic value of BNP on cardiac function

Heart failure is the end stage of many diseases. Heart failure can be divided into acute heart failure (AHF) and chronic heart failure (CHF). CHF is divided into grades I, II, III, and IV according to the New York Heart Association (NYHA) cardiac function classification. . Class I heart function is actually free of clinical symptoms of heart failure and can be called left ventricular dysfunction (LVD). The symptoms of acute decompensation in chronic heart failure are similar to those in acute heart failure. The reliability of clinical diagnosis of heart failure is poor, especially in primary care settings. Echocardiography is the most useful and reliable non-invasive method for diagnosing cardiac insufficiency. There are 120,000 suspected new cases of heart failure in the UK each year. It is difficult to perform echocardiography in such a large number of patients. Based on the close relationship between BNP and cardiac function, many researchers have done a lot of work to explore its clinical application. In the pathophysiological changes and diagnosis of CHF, the importance of BNP has been affirmed. Mukoyama et al. reported that the plasma BNP concentration in CHF patients was higher than normal, and was proportional to the severity of heart failure. Comparing the heart and plasma BNP levels between the normal group and the CHF group, they found that the BNP content in the ventricle of the normal person was 7.2% of that in the atrium, and the whole 30% of the heart, and CHF patients increased to 22% and 52%, respectively. The plasma BNP concentration of normal people is about 0.9±0.07fmol/ml, and the BNP/ANP value is about 0.16±0.02. ) BNP concentration: grade I is about 14.3±1.8fmol/ml; grade II is about 68.9±37.9fmol/ml; grade III is about 155.4±39.1fmol/ml; grade IV is about 267.3±79.9fmol/ml. And in patients with grades III and IV, the plasma BNP/ANP values were 1.44 and 1.72, respectively. BNP increased by 200-300 times compared with normal, while ANP was only 20-30 times. Therefore, it is believed that the increase in ventricular synthesis and secretion of BNP in CHF patients is the cause of plasma BNP rises in part and increases with the severity of heart failure. Selvais et al believed that BNP was superior to ANP in diagnosing CHF and its severity. They compared the concentrations of ANP and BNP in normal people, patients with coronary heart disease with normal left ventricular ejection fraction (LVEF), and patients with different degrees of CHF, and found that severe Heart failure (NYHA III~IV) BNP concentration (205±143pg/ml) was significantly higher than mild heart failure (NYHA~II) concentration (51±28pg/ml) (p<0.001), BNP difference between CHF and normal people and The ability of patients with coronary heart disease with normal LVEF was better than that of ANP (p<0.01), and the correlation between BNP concentration and LVEF was better than that of ANP (rBNP=-0.59, rANP=-0.30, p<0.05), and it was also used to determine the degree of CHF. Stronger than LVEF (p<0.05), BNP can be used to diagnose outpatient cardiovascular patients.