e0653 Level change of plasma BNP and the relationships to the left ventricular aneurysm formation and cardiac performance in patients with acute myocardial infarction

Objective To investigate the change of brain natriuretic peptide (BNP) in plasma and the relationships with the left ventricular aneurysm (LVA) and cardiac performance in acute myocardial infarction (AMI) patients using left ventriculography (LVG). Methods A total of 64 patients with primary anterior AMI accompanied LVA diagnosed by LVG were enrolled in this study and divided into LVA group (33 patients) and non-LVA group (31 patients). Plasma BNP was measured. At the immediately after PCI and 6th month after AMI, the parameters of LVEDVI, LVESVI, LVEF, WMS and LVEDP were measured by LVG. The main adverse cardiac events (MACE) were recorded during 24 week after PCI. Results The peak value of plasma BNP in LVA group was higher and the arrived time of peak values of peak time of plasma BNP was earlier than those in the non-LVA group (p<0.01, respectively). In 5th day and 24th week after AMI, the values of BNP in LVA group were higher as compared to those in non-LVA group (p<0.05, respectively). The peak value of plasma BNP in LVA group, regardless of whether LVEDP≥18 mm Hg or LVEDP<18 mm Hg, were higher than that in non-LVA group under the same level of LVEDP (p<0.05). At 6th month after AMI, the parameters of LVEF, LVESVI, LVEDVI, WMS and LVEDP in non-LVA group were much better as compared to those in LVA group. The peak value of plasma BNP was significantly correlated with LVESVI, LVEDVI, WMS, LVEDP in LVA group (p<0.01, respectively), while negatively correlated with LVEF at primary PCI (r=−0.72, p<0.01). During the 6 months follow-up, the incidence of MACE in LVA group were higher than that in the non-LVA group (p<0.05). The peak value of plasma BNP in LVA group was significantly correlated with the incidence of MACE (r=0.56, p<0.05). Conclusions The value of plasma BNP in the AMI patients with LVA was higher than that with non-LVA, and significantly correlated with left ventricular remodelling status and homodynamic change. It is indicated that the over secretion of BNP is involved in the left ventricular remodelling and the process of LVA formation.