CLINICAL SIGNIFICANCE OF DETERMINING THE LEVEL OF THE BRAIN NATRIURETIC PEPTIDE FOR THE DIAGNOSIS OF HEART FAILURE OF COMORBID PATIENTS WITH CORONARY HEART DISEASE AND THYROTOXICOSIS

Autor: E. V. Pashchenko, A. I. Chesnikova, V. I. Kudinov, V. P. Terent’ev
Jazyk: ruština
Rok vydání: 2017
Předmět:
Zdroj: Архивъ внутренней медицины, Vol 7, Iss 5, Pp 378-384 (2017)
Druh dokumentu: article
ISSN: 2226-6704
2411-6564
DOI: 10.20514/2226-6704-2017-7-5-378-384
Popis: Aim: To evaluate clinical significance of determining the level of the brain natriuretic peptide for the diagnosis of heart failure of comorbid patients with coronary heart disease and thyrotoxicosis. Materials and methods: 111 patients aged 45 to 65 years (average age was 58.3 ± 5.6 years) were included in the research. All the patients were divided into 4 groups: the main one consisted of 25 patients with thyrotoxicosis, coronary heart disease (CHD) and II-III functional class (FC) chronic heart failure (CHF); the 1st comparison group consisted of 30 patients with coronary heart disease and II -III FC CHF, but without thyroid dysfunction; the 2nd comparison group consisted of 30 patients with thyrotoxicosis without CHD; the 3rd comparison group consisted of 26 patients with thyrotoxicosis and coronary heart disease, without CHF. The following research methods were used in the work: the clinical state assessment scale (CSAS), the 6-minute walk test (6MWT), echocardiography. The level of the N-terminal pro-B-type natriuretic peptide (NT-proBNP) was determined using laboratory sets for enzyme immunoassay (Biomedica, Austria). Results: The comparative analysis of the CSAS indices did not reveal a significant difference in the severity of the clinical symptoms of CHF for the patients of the primary and the 1st comparison group (7.08 and 6.61, respectively, p> 0.05). At the same time, tolerance to physical activity for the patients of the main group was 1.2 times lower than for the patients of the 1st comparison group (p = 0.01). The contractility of left ventricular myocardium for the patients of the main group was significantly lower, as evidenced by the lowest left ventricular ejection fraction — 40.0 (37.0, 42.0)% (compared to patients of all comparison groups, p
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