黄岩
中国医学科学院阜外医院 心血管内科
BACKGROUND:Beta-blockers exert complex effects on plasma N-terminal-pro-B-type natriuretic peptide (NT-proBNP) level.HYPOTHESIS:We aimed to investigate whether NT-proBNP was still able to mirror the severity of chronic heart failure and predict the prognosis of the disease after administration of a beta-blocker.METHODS:Forty-four patients with chronic congestive heart failure were enrolled in the study to randomly receive carvedilol or bisoprolol in addition to background therapy. These patients underwent clinical measurement and blood sampling for NT-proBNP measurement at baseline and 3 or 7 months after the addition of the beta-blocker. The patients were followed-up for 3 years in order to register the occurrence of all-cause death.RESULTS:NT-proBNP level showed a positive correlation with the severity of heart failure as evaluated by New York Heart Association (NYHA) classification both before and after administration of either beta-blocker. The relationship between NT-proBNP and NYHA class was not weakened with the duration of therapy. Furthermore, NT-proBNP was the only independent predictor of all-cause mortality both before and after administration of either beta-blocker. Left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), age, NYHA class and treatment group were not independently predictive of mortality in this study.CONCLUSIONS:The ability of NT-proBNP to reflect the severity and to predict the endpoint in chronic heart failure is not undermined after administration of a beta-blocker, suggesting that NT-proBNP remains a sensitive biomarker for chronic heart failure both before and after administration of a beta-blocker.
Clinical cardiology 2007
In order to verify the relationship between blood pressure and cerebral blood flow velocity in sub-clinical natural population, 1294 middle-aged and old Beijing rural residents were investigated in autumn 2002. For all subjects, systolic blood flow velocities (V(s)) in common carotid artery (CCA), internal carotid artery (ICA) and middle cerebral artery (MCA) were detected with trans-cranial Doppler. Key factors such as anthropometry, medication use, blood pressure and blood biochemical analysis were investigated at the same time. After controlling for age, gender, diabetes, hypercholesterolaemia, smoking and body mass index, multivariate analysis showed that systolic blood pressure (SBP) correlated positively with V(s) at MCA and slight negatively correlated with at CCA. As blood pressure rose by 10 mm Hg, the V(s) at MCA increased by 1.63 cm/s. Duration of hypertension (HD) negatively correlated with V(s) at MCA (P<0.01). The V(s) at MCA in early-stage and chronic hypertensive patients were 92.9+/-1.9 and 84.1+/-2.3 cm/s, respectively. Antihypertensive treatment could modify the V(s) at MCA towards a normal level by lowering blood pressure. In conclusion, the effect of hypertension on cerebral blood flow is complex. V(s) at MCA positively correlated with SBP, but negatively related to HD. Antihypertensive treatment might be helpful to keep cerebral blood flow at a normal level.
Journal of human hypertension 2006
