Abstract:

ObjectiveTo investigate the relation between homocysteine (Hcy)， Nterminal Btype natriuretic peptide，structure and function of the left ventricular in elderly patients with chronic heart failure (CHF) . MethodsCHF group included 84 elderly patients with CHF， who were hospitalized in Cardiology at Xuanwu Hospital. According to the criterion of New York Heart Association (NYHA) class，CHF group was divided into three groups， cardiac function grade Ⅱ included 34 cases， grade Ⅲ 38 cases， grade Ⅳ  12 cases. At the same time， control group enrolled 78 cases of healthy people， who had health check in the hospital. Hcy  and NTproBNP were detected，the left ventricular enddiastolic diameter (LVEDD)， left ventricular ejection fraction (LVEF ) were measured in two groups using color Doppler ultrasound. CHF group was treated with routine therapies，and recombinant human brain natriuretic peptide(rhBNP)，first given 1.5 μg/kg loading dose， and then intravenous pump   0.01  μg·k-1·min-1 for 72 h.After treatment  for 7 days， the clinical data and laboratory results were collected. The data of two groups were compared and correlations were analyzed. Results①Hcy and NTproBNP in CHF group were significantly higher than those of control group(P<0.05); ② Hcy  and NTproBNP were the highest in  group of cardiac function Ⅳas compared with the groups of heart function Ⅱand Ⅲ(P<0.05); and Hcy and NTproBNP in group of cardiac function Ⅲ were higher than those of cardiac function Ⅱ group(P<0.05); ③Hcy and NTproBNP  sharply decreased after the heart failure symptoms improved(P<0.05). However， there were no significant differences in LVEDD， and LVEF before and after the treatment (P>0.05). ④There were positive correlation between the level of Hcy and NTproBNP（r=0.586，P<0.05）， LVEDD（r=0.284，P＜0.05），and the level of Hcy was negatively correlated with LVEF（r=-0.492，P＜0.05）.ConclusionThe level of Hcy  is increasing with the aggravating of heart failure and it has great relativity with NTproBNP， LVEDD and LVEF， so it can reflect the severity of heart failure.

Key words: heart failure, congestive, cysteine, Nterminal Btype natriuretic peptide, aged