Objective: To study the relationship of the level of N-terminal portion of brain natriuretic (NT-ProBNP) with the treatment and prognosis of patients with acute attack of chronic left heart failure.
Methods: Patients (age range 18-80 years) with decompensated heart failure treated in the emergency department in Fuwai Hospital were included in this study. Dynamic changes of plasma levels of NT-ProBNP, angiotensin (AO), renin activity (PRA), angiotensin II (AT II) and aldosterone (ALD) were detected by enzyme linked immunoadsorbent assay (ELISA) before anti-cardiac failure treatment and 3-5, 5-7 days after the treatment. All enrolled patients were followed up for 2 years after leaving hospital, and cardiovascular events such as death, myocardial infarction, worsening of heart failure, severe arrhythmia or delayed discharge from hospital were recorded.
Results: Compared with baseline level at admission, plasma NT-ProBNP levels were lowered on 3rd -5th day and 5th-7th day after admission and treatment (both P<0.05) in 44 patients with chronic left heart failure, but there was no difference in NT-ProBNP levels between the 3rd-5th and 5th -7th day after treatment. The levels of plasma NT-ProBNP increased much higher at all observation times in patients with cardiovascular events than without the events (all P<0.05), but the changes in AO, PRA, ATII and ALD showed no significant difference between two groups (all P>0.05).
Conclusion: During acute onset, plasma NT-ProBNP levels in patients with chronic left heart failure can be lowered at 3-7 days after admission and treatment. Higher baseline levels of plasma NT-ProBNP may have certain predictive values for long term prognosis in patients with chronic left heart failure.