Effect of B-type natriuretic peptide on clinical prognosis of patients with chronic heart failure

Objective To study the effect of B-type natriuretic peptide(BNP) on clinical diagnosis, cardiac function assessment and risk stratification of patients with congestive heart failure(CHF). Methods Two hundred and eight CHF patients were divided into grade 1 cardiac function group (group 1,n = 50),grade 2 cardiac function group(group 2,n = 51),grade 3 cardiac function group (group 3,n = 55) and grade 4 cardiac function group(group 4,n = 52) according to the cardiac function grading recommended by NYHA.Their plasma BNP level was measured by radioimmunoassay and LVEF was detected by color Doppler echocardiography.Results The plasma BNP level was 78.05±12.86 ng/L,235.38±36.65 ng/L,587.98±75.78 ng/L and 1203.87±189.96 ng/L,respectively,in groups 1-4,which was significantly higher in groups 2 - 4 than in group 1 (P0.01).The LVEF and 6-minute walk test(6MWT) distance decreased gradually with the increasing BNP level in CHF patients.The times of patients admitted to hospital increased with the severity of heart failure in groups 2 - 4.The 5-year death rate of groups 2 - 4 was 0%,18.18%,and 44.23%,respectively,during the follow-up period and the 5-year death risk increased with the increased BNP level or the insignificantly deceased BNP level after treatment(P0.01).The sensitivity and specificity of BNP in CHF patients with their LVEF50%were 82.35%and 75.42%, respectively.Conclusion Plasma BNP level is a rather good indication for the diagnosis of CHF and negatively related with the LVEF and 6MWT distance in CHF patients.