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  • 1 Gottsegen György Országos Kardiológiai Intézet Gyermekszív Központ Budapest
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Bevezetés: A kardiális biomarkerek közül a B-típusú natriureticus peptid mérése a felnőttkori kardiológiai diagnosztikában elfogadott, azonban a gyermekkardiológiai diagnosztikában még kevésbé vonult be a mindennapi diagnosztikai eljárások közé. Cél: A szerzők által korábban a szisztémás jobbkamra-funkció vizsgálatára bevezetett B-típusú natriureticus peptid vizsgálatok értékelése cardiomyopathiákban, valamint az eredmények összevetése a hagyományos echokardiográfiával és szöveti Dopplerrel nyert kamrai szisztolés és diasztolés paraméterekkel. Módszer: 2007 és 2010 között 32 betegben (20 dilatatív cardiomyopathia, 10 hypertrophiás cardiomyopathia, 2 non-compacted cardiomyopathia) 58 esetben történt meg a B-típusú natriureticus peptid mérése. A betegek átlagéletkora 7,9±6,6 év volt. A B-típusú natriureticus peptid koncentrációját elektrokemilumineszcenciás módszerrel határozták meg. Eredmények: Szignifikáns negatív korrelációt (r = –0,63; p<0,01) találtak a B-típusú natriureticus peptid értékek (tartomány: 12–7002 ng/l, átlag: 1531±1750 ng/l) és a százalékos rövidülési frakció értékei között (tartomány: 4–50%, átlag: 22,5±13%). A vizsgált mindhárom cardiomyopathiás csoportban a B-típusú natriureticus hormon koncentrációi szignifikánsan eltértek a normális értéktől (dilatatív cardiomyopathia: p<0,001; hypertrophiás cardiomyopathia: p<0,01; non-compacted cardiomyopathia: p<0,001). Jelentősen csökkent százalékos rövidülési frakció (<17%) esetén 1000 ng/l feletti B-típusú natriureticus peptid koncentráció cut-off értéknek bizonyult. A B-típusú natriureticus peptid koncentrációi a bal kamrai végdiasztolés átmérővel (r = 0,899; p<0,001), a bal kamrai anularis szisztolés hullámmal (r = 0,689; p<0,001), illetve a bal kamrai diasztolés funkcióra utaló E/e értékkel (r = 0,43; p<0,05) mutatták a legjobb korrelációt. Következtetések: A B-típusú natriureticus peptid vizsgálata minden típusú gyermekkori cardiomyopathiában ajánlott. Előnye, hogy egyszerű, nyomon követésre használható és jól jelzi a szisztolés-diasztolés funkciózavart, így vizsgálata nemcsak dilatatív, hanem hypertrophiás cardiomyopathiaban is ajánlott. Orv. Hetil., 2013, 154, 409–414.

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