慢性肺疾患の右室肥大のマーカーとしての血漿脳性ナトリウム利尿ペプチド

Plasma Brain Natriuretic Peptide Concentration as a Biochemical Marker for Right Ventricular Hypertrophy in Patients with Chronic Lung Disease

　健常者38例のLVmassに有意差のない慢性肺疾患患者24例（健常群98.1±13.5g・m⁻²vs慢性肺疾患群101.0±13.4g・m⁻²，心エコーPenn方式による）のうち，三尖弁逆流を認めた17例で心エコードプラー法で求めた右室収縮期圧と心筋SPECT右室・左室カウント比・RV／LV countとは正相関関係にあった（r＝0.822,p＜0.001）．慢性肺疾患患者24例においてRV／LVcountと血漿BNP濃度は正相関関係にあった（r＝0.865,p＜0.001）．加えて，健常群に比して慢性肺疾患群でBNP濃度が有意に高値を示した（健常群11.4±1.3pg／ml vs慢性肺疾患群22.6±19.8pg／ml,p＜0.001）．以上より慢性肺疾患患者の血中BNP濃度は右室肥大の生化学的マーカーになり得ることが示唆された．

Of 24 chronic lung disease patients with no significant difference in LV mass from 38 healthy volunteers (healthy volunteer group 98.1±13.5gm^-2 vs chronic lung disease group 101.1±13.4gm^-2 by Penn method echocar-diography), myocardial spect RV/LV count and plasma BNP levels were directly proportional in the 24 chronic lung disease patients (r=0.865, p＜0.001). RV systolic pressure obtained by Doppler echocardiography and myocardial spect RV/LV count ratio were directly proportional in 17 patients with tricuspid regurgitation (r=0.822, p＜0.001).

These results suggested that plasma BNP levels could be a biochemical marker for RV hypertrophy in patients with chronic lung disease.