Measurement of N-terminal pro-B-type natriuretic peptide(NT-proBNP)in hemodialysis patients-Examination by electrocardiogram-

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  • 血液透析患者のＮＴ－ｐｒｏＢＮＰ濃度測定の有用性　　‐心電図所見からの検討‐
  • 血液透析患者のNT-proBNP濃度測定の有用性--心電図所見からの検討
  • ケツエキ トウセキ カンジャ ノ NT proBNP ノウド ソクテイ ノ ユウヨウセイ シンデンズ ショケン カラ ノ ケントウ
  • ―心電図所見からの検討―

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N-terminal pro-B-type natriuretic peptide(NT-proBNP) is a new biomarker of both the cardiac function and heart failure. The serum concentrations of NT-proBNP increase in hemodialysis(HD) patients. This study examined the usefulness of NT-proBNP measurement in HD patients by examining the relationship between NT-proBNP and electrocardiographic(ECG) findings. This study observed 85 HD patients. The serum concentrations of NT-proBNP were measured by an electrochemiluminescence immunoassay(Elecsys 2010, Roche Diagnosics). RV5+SV1 voltage, RV5 voltage, QRS interval, QTc interval and QRS axis were used as ECG parameters. The serum NT-proBNP concentrations in HD patients(676~127,172 pg/mL) were significantly higher than healthy subjects(9~144 pg/mL). There was a significant positive correlation between NT-proBNP and RV5+SV1 voltage. A receiver-operating characteristic curve demonstrated about 8,000 pg/mL as the cut-off value for NT-proBNP that correlated with cardiac function abnormalities. HD patients were divided into two groups based on their NT-proBNP concentrations(<8,000 pg/mL group and ≥8,000 pg/mL group). The incidence of heart failure in the <8,000 pg/mL group was compared with that in the ≥8,000 pg/mL group. The incidence of heart failure in the ≥8,000 pg/mL group was 31.4%, which was significantly higher than that in the <8,000 pg/mL group;0.0%(p<0.0001). These findings suggest that the NT-proBNP concentrations are a useful marker of cardiac function as well as a predictor of heart failure in HD patients. The NT-proBNP cut-off value in HD patients was thus determined to be 8,000 pg/mL.

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