Clinical value of NT-proBNP, MPO, and NLR combined with echocardiography in prediction of malignant arrhythmia in elderly patients with valvular heart disease.
{"title":"Clinical value of NT-proBNP, MPO, and NLR combined with echocardiography in prediction of malignant arrhythmia in elderly patients with valvular heart disease.","authors":"Jianping Liu, Apei Zhou, Meiduan Zheng, Ling Wang, Ping Zeng","doi":"10.1186/s13741-025-00527-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>The combination of NT-proBNP, MPO, NLR, and echocardiography has a predictive value in detecting MA in elderly VHD patients.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":"14 1","pages":"44"},"PeriodicalIF":2.0000,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016093/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Perioperative Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13741-025-00527-7","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
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。