Objective: To explore the predictive value of NT-proBNP, neutrophil to lymphocyte ratio and quantitative tissue velocity imaging in cardiac dysfunction of patients with acute ST segment elevation myocardial infarction undergoing primary PCI. Methods: A total of 132 patients with STEMI who underwent primary PCI were enrolled in the study.The levels of NT-proBNP and NLR were measured before primary PCI. The corresponding segmental left ventricular wall motion velocity of diseased vessel was measured by quantitative tissue velocity imaging.The indexes including systolic peak elocity (Vs), early diastolic peak velocity (Ve), late diastolic peak velocity (Va) and Ve/Va were tested. Then we calculated out the mean systolic peak elocity (mVs), mean early diastolic peak velocity (mVe), mean late diastolic peak velocity (mVa) and mVe/mVa.The occurrence of cardiac dysfunction was followed up during 30 days after PCI. According to wheater cardiac dysfunction happened during 30-day follow up, the patients were divided into cardiac dysfunction group (n=27) and non-cardiac dysfunction group (n=105). NT-proBNP, NRL, Vs, mVe, mVa and mVe/mVa were compared between the two groups. Results: Compared with non -cardiac dysfunction group, the levels of NT-proBNP, NRL were significantly higher in cardiac dysfunction group(1 369.53±293.23 vs 346.18±39.9 pg·ml-1,P < 0.01;8.24 ±0.42 vs 5.49±0.25,P < 0.05),but mVs, mVe/mVa were significantly lower in cardiac dysfunction group(3.16±1.21 vs 5.64±1.48 cm·s-1,0.96±0.47 vs 1.88±0.76,P < 0.05). Correlation analysis indicated that NT-proBNP was positively correlated with NLR(r=0.264,P < 0.01),both NT-proBNP and NLR were negatively correlated with mVs and mVe/mVa(r=-0.399,P < 0.05; r=-0.146,P < 0.05; r=-0.401,P < 0.01; r=-0.584,P < 0.05). Multivariate logistic regression analysis showed that NT-proBNP>1 000 pg·ml-1 (P=0.014,OR=1.738,95%CI: 1.088~9.543), NLR>6.85(P=0.021,OR=2.104,95%CI: 1.274~10.652), mVs<4.5 cm·s-1 (P=0.018,OR=1.886,95%CI: 1.030~5.747) were the independent risk factors of cardiac dysfunction. Conclusion: Intergrated application of NT-proBNP, NLR, mVs and mVe/mVa may be more comprehensive and accurate in predicting the occurrence of cardiac dysfunction after primary PCI. It is of significance to identify patients with high risk of heart failure and give early intervention.
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