Clinical value of NT-proBNP, MPO, and NLR combined with echocardiography in prediction of malignant arrhythmia in elderly patients with valvular heart disease.
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引用次数: 0
Abstract
Objective: We aimed to probe the clinical value of N-terminus pro-brain natriuretic peptide (NT-proBNP), myeloperoxidase (MPO), and neutrophil lymphocyte ratio (NLR) combined with echocardiography in the prediction of malignant arrhythmias (MA) in elderly patients with valvular heart disease (VHD).
Methods: MPO, NT-proBNP, and NLR were detected in blood samples. After 1 year of follow-up, receiver operating characteristic curves were analyzed to determine the clinical value of NT-proBNP, MPO, NLR, and echocardiography for predicting MA in patients with VHD.
Results: MPO, NT-proBNP, and NLR were higher in the VHD group. MPO, NT-proBNP, and NLR were higher with severe cardiac dysfunction. MPO, NT-proBNP, NLR, and LVESV in the MA group were higher. NT-proBNP was an independent factor influencing the occurrence of MA in elderly patients with VHD. The AUC for predicting MA in elderly patients with VHD using NT-proBNP, MPO, NLR, and echocardiography were 0.782 (sensitivity 61.50%, specificity 94.60%, 95% CI 0.630-0.934), 0.759 (sensitivity 69.20%, specificity 81.10%, 95% CI 0.579-0.938), 0.736 (sensitivity 76.90%, specificity 64.90%, 95% CI 0.562-0.910), and 0.782 (sensitivity 76.90%, specificity 75.70%, 95% CI 0.646-0.918), respectively. The AUC for the combined prediction using NT-proBNP, MPO, NLR, and echocardiography was 0.913 (sensitivity 76.90%, specificity 94.60%, 95% CI 0.820-1.000), higher than that of each parameter alone (P < 0.05).
Conclusion: The combination of NT-proBNP, MPO, NLR, and echocardiography has a predictive value in detecting MA in elderly VHD patients.
目的：探讨n端脑利钠肽（NT-proBNP）、髓过氧化物酶（MPO）、中性粒细胞淋巴细胞比值（NLR）联合超声心动图预测老年瓣瓣膜性心脏病（VHD）患者恶性心律失常（MA）的临床价值。方法：检测血样中MPO、NT-proBNP、NLR。随访1年后，分析受试者工作特征曲线，确定NT-proBNP、MPO、NLR和超声心动图预测VHD患者MA的临床价值。结果：VHD组MPO、NT-proBNP、NLR较高。MPO、NT-proBNP和NLR在严重心功能障碍患者中较高。MA组MPO、NT-proBNP、NLR、LVESV升高。NT-proBNP是影响老年VHD患者MA发生的独立因素。NT-proBNP、MPO、NLR和超声心动图预测老年VHD患者MA的AUC分别为0.782（敏感性61.50%，特异性94.60%,95% CI 0.63 ~ 0.934）、0.759（敏感性69.20%，特异性81.10%,95% CI 0.579 ~ 0.938）、0.736（敏感性76.90%，特异性64.90%,95% CI 0.562 ~ 0.910）和0.782（敏感性76.90%，特异性75.70%,95% CI 0.646 ~ 0.918）。NT-proBNP、MPO、NLR和超声心动图联合预测的AUC为0.913（敏感性76.90%，特异性94.60%,95% CI 0.820 ~ 1.000），高于单独预测各参数的AUC (P结论：NT-proBNP、MPO、NLR和超声心动图联合预测老年VHD患者的MA有一定的预测价值。
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