NỒNG ĐỘ NT-PROBNP HUYẾT TƯƠNG Ở NGƯỜI BỆNH SAU CẤY MÁY TẠO NHỊP TIM VĨNH VIỄN

Abstract

Objective: To evaluate the changes in plasma NT-proBNP levels before and after permanent pacemaker implantation, as well as the relationship between post-implantation plasma NT-proBNP levels and clinical symptoms, paraclinical tests, and pacemaker parameters in patients with third-degree atrioventricular block (AVB) who received a permanent pacemaker. Subjects and Methods: This is a prospective, cross-sectional, intervention-controlled descriptive study involving 60 patients with third-degree AVB who underwent permanent pacemaker implantation at Vietnam National Heart Institute, Bach Mai Hospital, Dong Do Hospital, and Vietnam-Sweden Hospital in Uong Bi from August 1, 2022 to August 31, 2023. Patients meeting the inclusion criteria were recruited using convenience sampling and divided into two groups: Group 1 consisted of patients who switched to a single-chamber pacing mode post-implantation, while Group 2 included those who maintained a dual-chamber pacing mode. Results: In patients with third-degree AVB who received permanent pacemakers, plasma NT-proBNP levels after implantation were higher than before implantation in both groups. In Group 1, the values were 354.57±249.49 pg/ml before implantation and 495.90±290.28 pg/ml after implantation, with a statistically significant difference (p<0.001). In Group 2, the levels were 568.44±276.53 pg/ml before and 658.96±376.40 pg/ml after implantation, also showing a statistically significant difference (p=0.027). A strong negative correlation was found between plasma NT-proBNP levels and ejection fraction (EF) after permanent pacemaker implantation (r = -0.464, p<0.05) in the dual-chamber pacing group. Conclusion: In patients with third-degree AVB who received permanent pacemakers, plasma NT-proBNP levels were significantly higher post-implantation compared to pre-implantation levels in both the single-chamber and dual-chamber pacing groups. A strong negative correlation existed between plasma NT-proBNP levels and EF between plasma NT-proBNP levels and EF in the dual-chamber pacing group and a moderate positive correlation with right ventricular electrode impedance in the dual-chamber pacing group; however, no such correlation was found in the single-chamber pacing group.