Korean Journal of Clinical Laboratory Science (대한임상검사과학회지)

Korean Society for Clinical Laboratory Science (대한임상검사과학회)
권호 표지
DOI QR코드

DOI QR Code

Study on the Relationship between Pro-Brain Natriuretic Peptide and Routine Blood Test Factors at a General Hospital in Gyeonggi-do

경기도 일개 종합병원에서 Pro-Brain Natriuretic Peptide와 통상적 혈액검사 인자간의 상관성 조사

  • Park, Dong Yeop (Department of Clinical Laboratory Medicine, Dongsuwon General Hospital) ;
  • Kim, Sang-Su (Hubiotechms Corporation) ;
  • Sung, Hyun Ho (Department of Clinical Laboratory Science, Dongnam Health University) ;
  • Park, Chang-Eun (Department of Biomedical Laboratory Science, Namseoul University)
  • 박동엽 (동수원병원 진단검사의학과) ;
  • 김상수 (휴바이오텍엠에스) ;
  • 성현호 (동남보건대학교 임상병리과) ;
  • 박창은 (남서울대학교 임상병리학과)
  • Received : 2020.08.18
  • Accepted : 2020.09.06
  • Published : 2020.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

This study investigated retrospectively the correlation between the results of the N-terminal pro-brain natriuretic peptide (NT-proBNP) and a routine blood test using a hospital information system. The NT-proBNP is involved in the pathophysiology of heart failure. The results show that the relationship between age and NT-proBNP was significant (P<0.01) with a positive correlation (r=0.163). The peptide concentration showed a negative correlation between the total protein (r=-0.250) and albumin (r=-0.270), and a negative correlation between the erythrocyte count and hemoglobin and hematocrit (P<0.01). NT-proBNP had a positive correlation with neutrophils (r=0.227) and a negative correlation with lymphocytes (r=-0.236), showing significant results (P<0.01). NT-proBNP and creatinine showed a positive correlation (r=0.594, P<0.01), and it was the most influential factor according to multiple regression analysis (B=0.53, t=7.65). P<0.01). The concentrations of NT-proBNP and uric acid showed a positive correlation (r=0.180, P<0.05). Lactate dehydrogenase was observed as a factor affecting the NT-proBNP (B=0.20, t=3.28, P<0.01). This explanatory power had an influence of 43%. Therefore, the accurate test and related factors of the NT-proBNP have significant clinical value.

본 연구의 목적은 병원정보시스템을 활용하여 N-말단 프로-뇌 나트륨 이뇨 펩타이드(N-terminal pro-brain natriuretic peptide, NT-proBNP)의 결과와 통상적인 혈액검사와의 상관성을 후향적으로 조사하는 것이다. NT-proBNP는 심부전의 병태 생리학에 관여한다. 본 연구결과는 연령과 NT-proBNP의 관계는 양의 상관관계(r=0.163)로 통계적으로 유의하였다(P<0.01). NT-proBNP 농도는 총 단백질(r=-0.250)과 알부민(r=-0.270)은 음의 상관관계, 적혈구수와 혈색소 그리고 적혈구 용적률은 음의 상관관계로 나타난 결과로 나타났다(P<0.01). NT-proBNP는 호중구와 양의 상관관계(r=0.227)와 림프구는 음의 상관관계(r=-0.236)로 통계적으로 유의한 결과가 나타났다(P<0.01). NT-proBNP와 크레아티닌은 양의 상관관계로 나타났으며(r=0.594, P<0.01), 다중회귀분석결과 가장 영향을 미치는 인자로 관찰되었다(B=0.53, t=7.65, P<0.01). NT-proBNP와 요산의 농도는 양의 상관관계로 유의한 관계를 나타냈다(r=0.180, P<0.05). 젖산탈수소효소가 NT-proBNP에 영향을 미치는 인자로 관찰되었다(B=0.20, t=3.28, P<0.01). 이러한 설명력은 43%의 영향력을 나타내어 NT-proBNP의 정확한 검사와 관련인자들은 심장표지자로서 임상적 가치가 있는 것으로 사료된다.

Keywords

References

  1. McMurray JJ, Adamopoulos S, Anker SD, Auricchio A, Bohm M, Dickstein K, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2012;33:1787-1847. https://doi.org/10.1093/eurheartj/ehs104
  2. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;62:147-239. https://doi.org/10.1161/CIR.0b013e31829e8776
  3. Lee JH, Lim NK, Cho MC, Park HY. Epidemiology of heart failure in Korea: present and future. Korean Circ J. 2016;46:658-664. https://doi.org/10.4070/kcj.2016.46.5.658
  4. Davie AP, Francis CM, Love MP, Caruana L, Starkey IR, Shaw TR, et al. Value of the electrocardiogram in identifying heart failure due to left ventricular systolic dysfunction. BMJ. 1996;312:222. https://doi.org/10.1136/bmj.312.7025.222
  5. Khunti K, Squire I, Abrams KR, Sutton AJ. Accuracy of a 12-lead electrocardiogram in screening patients with suspected heart failure for open access echocardiography: a systematic review and meta-analysis. Eur J Heart fail. 2004;6:571-576. https://doi.org/10.1016/j.ejheart.2004.03.013
  6. Madias JE. Why recording of an electrocardiogram should be required in every inpatient and outpatient encounter of patients with heart failure. Pacing Clin Electrophysiol. 2011;34:963-967. https://doi.org/10.1111/j.1540-8159.2011.03131.x
  7. Kirkpatrick JN, Vannan MA, Narula J, Lang RM. Echocardiography in heart failure: applications, utility, and new horizons. J Am Coll Cardiol. 2007;50:381-396. https://doi.org/10.1016/j.jacc.2007.03.048
  8. Dokainish H, Nguyen JS, Bobek J, Goswami R, Lakkis NM. Assessment of the American Society of Echocardiography-European Association of Echocardiography guidelines for diastolic function in patients with depressed ejection fraction: an echocardiographic and invasive haemodynamic study. Eur J Echocardiogr. 2011;12:857-864. https://doi.org/10.1093/ejechocard/jer157
  9. Groenveld HF, Januzzi JL, Damman K, van Wijn gaarden J, Hillege HL, van Veldhuisen DJ, et al. Ane mia and mortality in heart failure patients a systematic review and meta-analysis. J Am Coll Cardiol. 2008;52:818-827. https://doi.org/10.1016/j.jacc.2008.04.061
  10. Schrier RW. Water and sodium retention in edema tous disorders: role of vasopressin and aldosterone. Am J Med. 2006;119:47-53. https://doi.org/10.1016/j.amjmed.2006.05.007
  11. Gheorghiade M, Abraham WT, Albert NM, Gattis Stough W, Greenberg BH, O'Connor CM, et al. Relationship between admission serum sodium concen tration and clinical outcomes in patients hospitalized for heart failure: an analysis from the OPTIMIZE-HF registry. Eur Heart J. 2007;28:980-988. https://doi.org/10.1093/eurheartj/ehl542
  12. Campbell RC, Sui X, Filippatos G, Love TE, Wahle C, Sanders PW, et al. Association of chronic kidney disease with outcomes in chronic heart failure: a propensity-matched study. Nephrol Dial Transplant. 2009;24:186-193. https://doi.org/10.1093/ndt/gfn445
  13. Dries DL, Exner DV, Domanski MJ, Greenberg B, Stevenson LW. The prognostic implications of renal in sufficiency in asymptomatic and symptomatic patients with left ventricular systolic dysfunction. J Am Coll Cardiol. 2000;35:681-689. https://doi.org/10.1016/s0735-1097(99)00608-7
  14. Januzzi JL, Jr., Camargo CA, Anwaruddin S, Bag gish AL, Chen AA, Krauser DG, et al. The N-terminal pro-BNP investigation of dyspnea in the emergency department (PRIDE) study. Am J Cardiol. 2005;95:948-954. https://doi.org/10.1016/j.amjcard.2004.12.032
  15. Doust JA, Glasziou PP, Pietrzak E, Dobson AJ. A systematic review of the diagnostic accuracy of natriuretic peptides for heart failure. Arch Intern Med. 2004;164:1978-1984. https://doi.org/10.1001/archinte.164.18.1978
  16. Maisel A, Mueller C, Adams K, Jr., Anker SD, Aspro monte N, Cleland JG, et al. State of the art: using natriuretic peptide levels in clinical practice. Eur J Heart Fail. 2008;10:824-839. https://doi.org/10.1016/j.ejheart.2008.07.014
  17. Kelder JC, Cramer MJ, Verweij WM, Grobbee DE, Hoes AW. Clinical utility of three B-type natriuretic peptide assays for the initial diagnostic assessment of new slow-onset heart failure. J Card Fail. 2011;17:729-734. https://doi.org/10.1016/j.cardfail.2011.04.013
  18. Lindenfeld J, Albert NM, Boehmer JP, Collins SP, Ezekowitz JA, Givertz MM, et al. HFSA 2010 Comprehensive heart failure practice guideline. J Card Fail. 2010;16:1-194. https://doi.org/10.1016/j.cardfail.2010.04.004
  19. Yoo BS. Biomarkers in heart failure: focus on B-type natriuretic peptide. Korean J Med. 2012;82:647-650. https://doi.org/10.3904/kjm.2012.82.6.647
  20. Choi SH. Acute heart failure and its management. J Neurocrit Care. 2018;11:13-22. https://doi.org/10.18700/jnc.180047
  21. Sopenaa AC, Fontana A, Lalanaa ME, Sancheza M, Crespob A, Tapiaa A. Correlation study of a new method for measuring NT-proBNP. Clinica Chimica Acta. 2019;493:170-198. https://doi.org/10.1016/j.cca.2019.03.374
  22. Hirata T, Arai Y, Yuasa S, Abe Y, Takayama M, Sasaki T, et al. Associations of cardiovascular biomarkers and plasma albumin with exceptional survival to the highest ages. Nat Commun. 2020;11:1-17. https://doi.org/10.1038/s41467-020-17636-0
  23. Schulz H, Langvik TA, Lund Sagen E, Smith J, Ahmadi N, Hall C. Radioimmunoassay for N-terminal probrain natriuretic peptide in human plamsa. Scand J Clin Lab Invest. 2001;61:33-42. https://doi.org/10.1080/00365510151067947
  24. Karakoyun I, Colak A, Arslan FD, Hasturk AG, Duman C. Anemia considerations when assessing natriuretic peptide levels in ED patients. Am J Emerg Med. 2017;35:1677-1681. https://doi.org/10.1016/j.ajem.2017.05.048
  25. Farzaneh F, Faghih N, Hosseini MS, Arab M, Ashrafganjoei T, Bahman A. Evaluation of neutrophil-lymphocyte ratio as a prognostic factor in cervical intraepithelial neoplasia recurrence. Asian Pac J Cancer Prev. 2019;20:2365-2372. https://doi.org/10.31557/APJCP.2019.20.8.2365
  26. Cui H, Huo G, Liu L, Fan L, Ye P, Cao J, et al. Association of cardiac and renal function with extreme N-terminal fragment pro-B-type natriuretic peptide levels in elderly patients. BMC Cardiovac Disord. 2012;12:57. https://doi.org/10.1186/1471-2261-12-57
  27. Udani SM, Koyner JL. The effects of heart failure on renal function. Cardiol Clin. 2010;28:453-465. https://doi.org/10.1016/j.ccl.2010.04.004
  28. Sabaka P, Dukat A, Gajdosik J, Caprnda M, Bendzala M, Simko F. Uric acid level is positively associated with NT-proBNP concentration in Slovak heart failure patients. Physiol Res. 2019;68:767-774. https://doi.org/10.33549/physiolres.934186
  29. He H, Liu J, Jiang H, Du J, Li L, et al. High serum lactate dehydrogenase adds prognostic value to cardiac biomarker staging system for light chain amyloidosis. J Cancer. 2019;10:5622-5627. https://doi.org/10.7150/jca.30345
  30. Alawieh H, El Chemaly T, Alam S, Khraiche M. Towards point-of-care heart failure diagnostic platforms: BNP and NT-proBNP biosensors. Sensors. 2019;19:5003. https://doi.org/10.3390/s19225003