학술대회안내사전등록초록등록안내초록등록/관리숙박 및 교통
초록심사

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ǥ : ȣ - 480163   201 
Degree of left ventricular hypertrophy determines plasma NT pro-BNP level in hypertrophic cardiomyopathy
Department of Medicine, Sungkyunkwan University School of Medicine, Cardiac and Vascular Center, Samsung Medical Center
Seon Woon Kim, Yu Jeong Choi, Sang-Chol Lee, Seung Woo Park, Sang Hoon Lee, Jeong Euy Park, Eun-Seok Jeon
Background: N-Terminal Pro-Brain Natriuretic Peptide (NT pro-BNP) is a neurohormone secreted from the ventricular myocardium in response to left ventricular (LV) wall stress. However, the determinants of NT pro-BNP level have not been clarified in hypertrophic cardiomyopathy (HCM). This study was performed to determine the relationship of NT pro-BNP level and various echocardiographic variables in HCM. Methods: We assessed the echocardiographic variables of 36 patients (M:F=19:17, 58±14 years) with HCM who has no persistent atrial fibrillation nor significant mitral regurgitation. Plasma NT pro-BNP levels were measured in stable hemodynamic condition. LV end-diastolic and end-systolic volume, LV volume index (LV volume/body surface area, BSA), LV ejection fraction, LV fractional shortening, LV mass, LV mass index (LV mass/BSA), left atrial (LA) volume, and LA volume index (LA volume/BSA) were measured by two dimensional echocardiography. LV outflow tract (LVOT) pressure gradient, transmitral E/A ratio (E/A), transmitral peak E velocity/septal annular E’ velocity (E/E’), and deceleration time were also measured by Doppler echocardiography. The relationship between echocardiographic variables and plasma NT pro-BNP level was analyzed. Results: Mean NT pro-BNP level was 775.2±994.2 ng/L (range 33.1-4729 ng/L). The NT pro-BNP level were correlated positively with LV end-diastolic septal thickness (r=0.385, p=0.010) and LV mass index (r=0.265, p=0.050). Meanwhile, NT pro-BNP level had negative correlations with the LV end-diastolic diameter (r=-0.437, p=0.004), end-diastolic volume (r=-0.435, p=0.004) and deceleration time (r=-0.308, p=0.034). In multivariable analysis, NT pro-BNP level was independently related to LV end-diastolic diameter (p=0.001), LV mass index (p=0.006) and deceleration time (p=0.031). The existence of LVOT obstruction had no impact on plasma NT pro-BNP levels. Conclusion: In patients with HCM, the degree of LV hypertrophy may be more important factor than LV contractile function in determining plasma NT pro-BNP level.


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