[The prognostic significance of plasma cyclic nucleotides in patients with congestive heart failure].
摘要
The relationship between plasma levels of cyclic nucleotides and mortality was studied in 108 patients with congestive heart failure (CHF) in whom plasma cAMP and cGMP, were determined by radioimmunoassay and were followed-up for 36 to 48 months. 29 patients died. The plasma concentrations of cAMP and cGMP in the dead group were significantly higher than those in the survival group (27.41 +/- 6.11 and 31.11 +/- 18.23 vs 21.56 +/- 5.37 and 17.45 +/- 9.35 nmol/L, respectively, mean +/- s, P < 0.001). Compared with patients with cAMP concentrations below the median value of 22.31 nmol/L, those with higher levels of cAMP had a higher mortality rate (46.3% vs 7.4%, P < 0.001). Patients with cGMP levels above the median value of 17.24 nmol/L also had a higher mortality rate than those with lower levels (40.7% vs 13.0%, P < 0.01). Multivariate stepwise regression analysis including age, cardiac function classification, heart rate, serum potassium and sodium, plasma cAMP, cGMP and cAMP/cGMP was carried out and revealed that only plasma cAMP and cGMP could provide independent prognostic information. Thus plasma levels of cyclic nucleotides was considered the excellent predictor for patients with CHF.