Kalp Yetersizliğinde B-çizgileri ile NT-ProBNP Düzeyleri Arasında Güçlü ve Direkt Korelasyon

Öz

Çalışmanın amacı, odaklanmış akciğer ultrasonu üzerindeki B-çizgilerinin sayısının, New York Kalp Derneği'nin (NYHA) klinik kalp yetmezliği sınıflaması ve acil serviste NT-proBNP düzeyleriyle ilişkisini değerlendirmekti. Bu ileriye dönük çalışma, bir üçüncü basamak üniversite hastanesinin acil servisinde gerçekleştirildi. Ocak 2016 ile Temmuz 2016 tarihleri arasında nefes darlığı yakınması veya kalp yetmezliği tanısı olan 18 yaş üstü hastalar çalışmaya alındı. Hastaların BLUE protokolünde belirtilen bölgelere göre B çizgisi sayısı ölçüldü. Klinik kalp yetmezliği evresi, NT-proBNP düzeyi ve akciğer ultrasonografisindeki B-çizgisi sayısı arasındaki ilişkiler analiz edildi. Toplam 143 hastanın 92'si (% 64,3) erkek, 51'i (% 35,7) kadındı. Ortanca yaş 73,00 (66,00-79,00) idi. Her bölge için B çizgilerinin sayısı ve NYHA aşamaları arasında çok güçlü bir korelasyon vardı (tüm değişkenler için r >0.85; tümü için p <0.001). Ayrıca her bölge için B çizgilerinin sayısı ile NT-proBNP seviyeleri arasında güçlü ve doğrudan bir korelasyon vardı (r> 0.70; p <0.001). Nefes darlığı sayısal skoru (r> 0.45; p <0.001) ile ejeksiyon fraksiyonu (EF) arasında ters bir ilişki vardı. EF ve BLUE noktaları arasındaki ilişki orta düzeyde, ancak negatif ve anlamlıydı (p <0.001). NT-proBNP seviyeleri, NHYA sınıflandırması ve akciğer ultrasonu, acil serviste akciğer konjesyonunda daha hızlı tanı ve karar verme için bir araç olarak kullanılabilir.

Anahtar Kelimeler

• kalp yetersizliği
• NT-proBNP
• B-çizgileri
• akciğer ultrasonu

Strong and Direct Correlation in Heart Failure Between B-Lines and NT-ProBNP Levels

Öz

The aim of the study was to evaluate the compliance of the number of B-lines on focused lung ultrasound with the clinical heart failure classification of the New York Heart Association (NYHA) and NT-proBNP levels in the emergency department. This prospective study was conducted in a tertiary university hospital emergency department. Patients over 18 years of age complaining of shortness of breath or heart failure diagnosis between January 2016 and July 2016. The number of B-lines according to the BLUE point regions was measured. Correlations between the clinical heart failure stage, NT-proBNP level and number of B-lines on ultrasonography were analyzed. Of the 143 patients, 92 (64.3%) were male and 51 (35.7%) were female. The median age was 73.00 (66.00-79.00). There was a very strong correlation between the number of B-lines and NYHA stages for each region (r > 0.85 for all variables; p <0.001 for all). There was also a strong and direct correlation between the number of B-lines and the NT-proBNP levels for each region (r > 0.70; p <0.001). Regarding the shortness of breath numerical score (r > 0.45; p <0.001), there was an inverse relationship with ejection fraction (EF). The relationship between the EF and BLUE points was moderate, but negative and significant (p <0.001). NT-proBNP levels, the NHYA classification, and lung ultrasound can be used as a tool in the emergency department for a faster diagnosis and decision-making in lung congestion.

Anahtar Kelimeler

• heart failure
• NT-proBNP
• B-lines
• lung ultrasound

Kaynakça

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