Aims Serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and B-type natriuretic peptide (BNP) levels are rarely evaluated simultaneously in the acute phase of acute heart failure (AHF). Method and results A total of 1207 AHF patients were enrolled, and 1002 patients were analysed. Blood samples were collected within 15 min of admission. Patients were divided into two groups according to the median value of the NT-proBNP/BNP ratio [low-NT-proBNP/BNP group (Group L) vs. high-NT-proBNP/BNP group (Group H)]. A multivariate logistic regression model showed that the C-reactive protein level (per 1-mg/dL increase), Controlling Nutrition Status score (per 1-point increase), and estimated glomerular filtration rate (eGFR, per 10-mL/min/1.73 m2 increase) were independently associated with Group H [odds ratio (OR) 1.049, 95% confidence interval (CI) 1.009–1.090, OR 1.219, 95% CI 1.140–1.304, and OR 1.543, 95% CI 1.401–1.698, respectively]. A Kaplan–Meier curve analysis showed that the prognosis was significantly poorer in Group H than in Group L, and a multivariate Cox regression model revealed Group H to be an independent predictor of 180-day mortality [hazard ratio (HR) 3.084, 95% CI 1.838–5.175] and HF events (HR 1.963, 95% CI 1.340–2.876). The same trend in the prognostic impact was significantly observed in the low-BNP (<810 pg/mL, n = 501), high-BNP (≥810 pg/mL, n = 501), and low-eGFR (<60 mL/min/1.73 m2, n = 765) cohorts, and tended to be observed in normal-eGFR (≥60 mL/min/1.73 m2, n = 237) cohort. Conclusion A high NT-proBNP/BNP ratio was associated with a non-cardiac condition (e.g. inflammatory reaction, nutritional status, and renal dysfunction) and is independently associated with adverse outcomes in AHF.

中文翻译：

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N端脑利钠肽前体与B型利钠肽比值在急性心力衰竭急性期的临床意义

目的在急性心力衰竭 (AHF) 的急性期很少同时评估血清 N 末端脑利钠肽前体 (NT-proBNP) 和 B 型利钠肽 (BNP) 水平。方法与结果 共纳入 AHF 患者 1207 例，对 1002 例患者进行分析。入院后 15 分钟内采集血样。根据 NT-proBNP/BNP 比值的中值将患者分为两组[低-NT-proBNP/BNP 组（L 组）与高-NT-proBNP/BNP 组（H 组）]。多变量逻辑回归模型显示 C 反应蛋白水平（每增加 1-mg/dL）、控制营养状态评分（每增加 1 点）和估计的肾小球滤过率（eGFR，每 10-mL/min/增加 1.73 m2）与 H 组独立相关[优势比 (OR) 1.049, 95% 置信区间 (CI) 1。009–1.090、OR 1.219、95% CI 1.140–1.304 和 OR 1.543、95% CI 1.401–1.698]。Kaplan-Meier 曲线分析显示，H 组的预后明显低于 L 组，多变量 Cox 回归模型显示 H 组是 180 天死亡率的独立预测因子 [风险比 (HR) 3.084, 95% CI 1.838–5.175] 和 HF 事件 (HR 1.963, 95% CI 1.340–2.876)。在低 BNP (<810 pg/mL, n = 501)、高 BNP (≥810 pg/mL, n = 501) 和低 eGFR (<810 pg/mL, n = 501) 中观察到相同的预后影响趋势。 60 mL/min/1.73 m2, n = 765) 队列，并且倾向于在正常 eGFR (≥60 mL/min/1.73 m2, n = 237) 队列中观察到。结论 高 NT-proBNP/BNP 比率与非心脏疾病（如炎症反应、营养状况、