Utility of NT-proBNP for identifying LV failure in patients with acute exacerbation of chronic bronchitis.

BACKGROUND: NT-proBNP has been widely regarded as a useful tool for diagnosis or exclusion of heart failure (HF) in many settings. However, in patients with acute exacerbation of chronic bronchitis (AECB), its roles have not been well described. The objective of this study was to evaluate the diagnostic performance of NT-proBNP for identifying left ventricular (LV) failure in such patients. METHODS AND RESULTS: 311 AECB patients and 102 stable chronic bronchitis patients with no history of HF were enrolled. Plasma NT-proBNP concentrations were measured using Roche Elecsys. The European Society of Cardiology (ESC) diagnostic principles were adopted to identify HF and the diagnostic performance of NT-proBNP was evaluated by ROC. Our results showed, the median NT-proBNP level in patients with LV failure [4828.4 (2044.4-9203.6) ng/L] was significantly higher than that in those without LV failure [519.2 (179.1-1409.8) ng/L, p<0.001] and stable controls [207.5 (186.5-318.2) ng/L, p<0.001]. LV failure, renal function, atrial fibrillation and systolic pulmonary artery pressure were independent predictors of NT-proBNP levels (all p<0.05). The area under ROC curve (AUC) of NT-proBNP for identifying LV failure was 0.884, significantly superior to clinical judgment alone (AUC 0.835, p = 0.0294). At the optimal cutoff value of 935.0 ng/L, NT-proBNP yielded sensitivity 94.4%, specificity 68.2%, accuracy 74.3% and negative predictive value 97.6%. Adding the results of NT-proBNP to those of clinical judgment improved the diagnostic accuracy for LV failure. CONCLUSION: As a tool for diagnosis or exclusion of HF, NT-proBNP can help physicians identify LV failure in patients with AECB.

[Effect of Yishen Tiaojing Recipe on hypogonadism induced by Tripterygium glycosides in women patients with nephropathy].

OBJECTIVE: To explore the effect of Yishen Tiaojing Recipe (YSTJR) on sex gland and kidney in nephropathy patients with hypogonadism induced by Tripterygium glycosides (TG). METHODS: Fifty-eight women patients with chronic glomerular disease were assigned to two groups, the 34 patients in the treated group were given TP 20 mg three times a day plus YSTJR, one dose daily, while the 24 in the control group were given TP 20 mg three times a day alone. The course of treatment lasted for 3 months. Serum levels of estradiol (E2), follicle-stimulating hormone (FSH), and luteotrophic hormone (LH), as well as urinary protein and red blood cell (RBC) count in urine were determined before and after treatment. RESULTS: Level of E2 decreased, FSH and LH increased in the control group after treatment (P < 0.05), while those indexes unchanged in the treated group. Quantity of urinary protein decreased in both two groups after treatment (P < 0.05), but the decrement was more significant in the treated group than in the control group (P < 0.05). Differences of all the above-mentioned indexes between the two groups after treatment were significant (all P < 0.05). CONCLUSION: YSTJR could prevent the injury of TP on sex gland in women patients with nephropathy, and is benificial for the treatment of primary chronic renal glomerular diseases.