Application of N-terminal pro-brain natriuretic peptide in polymyositis/dermatomyositis with early left ventricular diastolic dysfunction / 中华风湿病学杂志

ABSTRACT

Objective To investigate the availability of N-terminal pro-brain natriuretic peptide (NT proBNP) in the detection of early ventricular diastolic dysfunction by polymyositis/dermatomyositis (PM/DM).Methods A total of 46 PM/DM patients without symptoms of heart involvement were prospectively studied by standard echocardiography and the longitudinal mitral annular velocities was measured by tissue Doppler echocardiography (TDI).Plasma NT-proBNP was measured in all patients.Multivariate Logistics regression analysis was applied to investigate the risk factors for early cardiac complications.The availability of NTproBNP was evaluated by receiver operating characteristic (ROC) analysis.Results There were 22 patients complicated with early diastolic dysfunction (E/Em ≥ 8) by TDI.The multi-factors Logistic regression analysis showed that the age of onset (OR=1.117,95％CI 1.005-1.243,P=0.040) and plasma NT-proBNP (OR=1.022,95％CI 1.001-1.042,P=0.036) were risk factors for early left ventricular diastolic dysfunction.The level of NT-proBNP was positively correlated with E/Em value(r=0.687,P=0.000).ROC showed NT-proBNP could reliably detectearly ventricular diastolic dysfunction [area under the curve 0.858 (95％ CI 0.735-0.981,P＜0.01)].If PM/DM patients with normal TDI(E/Em＜8) were used as controls,and 120 pg/ml was used as the cut-off concentration,the sensitivity and specificity of NT-proBNP for the early ventricular diastolic dysfunction was 81.8％ and 91.7％ respectively.Conclusion Age at onset and plasma NT-proBNP are risk factors for early left ventricular diastolic dysfunction.The level of NT-proBNP is positively correlated with E/Em value.The plasma NT-proBNP concentration higher than 120 pg/ml maybe a marker for early left ventricular diastolic dysfunction.