Title

Relation of N-terminal pro-B-type natriuretic peptide with diastolic function in hypertensive heart disease

Authors

Imran Uraizee, Brigham and Women’s Hospital
Susan Cheng, Brigham and Women’s Hospital
Chung-Lieh Hung, Mackay Memorial Hospital
Anil Verma, Ochsner Clinic Foundation
James D. Thomas, Cleveland Clinic Foundation
Michael R. Zile, Medical University of South Carolina
Gerard P. Aurigemma, University of Massachusetts Medical SchoolFollow
Scott D. Solomon, Brigham and Women’s Hospital

UMMS Affiliation

Department of Medicine, Division of Cardiovascular Medicine

Publication Date

2013-10-01

Document Type

Article

Subjects

Aged; Diastole; Echocardiography; Female; Humans; Hypertension; Male; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; Ventricular Dysfunction, Left

Disciplines

Cardiology | Cardiovascular Diseases

Abstract

BACKGROUND: Elevated natriuretic peptide levels in asymptomatic individuals without heart failure are associated with increased risk of adverse cardiovascular outcomes and may reflect subclinical cardiac dysfunction.

METHODS: In a sample of 313 asymptomatic individuals (51% women, mean age 61 years) with hypertension and diastolic dysfunction, we examined the association of plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) with both conventional and advanced echocardiographic measures of systolic and diastolic function, including myocardial strain, using speckle-tracking-based analyses.

RESULTS: In univariate analyses, higher NT-proBNP was associated with greater left ventricular mass index (P = 0.003), left atrial volume index (P = 0.007), lateral E' velocity (P < 0.0001), E/E' ratio (P < 0.0001), peak global longitudinal systolic strain (P = 0.015), systolic strain rate (P = 0.021), and early diastolic strain rate (P < 0.0001). In multivariable analyses, NT-proBNP remained associated with measures of diastolic dysfunction, including lateral E' velocity (P = 0.013) and the E/E' ratio (P = 0.008). However, early diastolic strain rate was the echocardiographic parameter most strongly associated with NT-proBNP (P = 0.003).

CONCLUSIONS: In the setting of asymptomatic hypertensive heart disease and preserved ejection fraction, elevation in natriuretic peptide levels is predominantly associated with subclinical diastolic dysfunction.

DOI of Published Version

10.1093/ajh/hpt098

Source

Am J Hypertens. 2013 Oct;26(10):1234-41. doi: 10.1093/ajh/hpt098. Epub 2013 Jun 22. Link to article on publisher's site

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

American journal of hypertension

PubMed ID

23792241

Repository Citation

Uraizee I, Cheng S, Hung C, Verma A, Thomas JD, Zile MR, Aurigemma GP, Solomon SD. (2013). Relation of N-terminal pro-B-type natriuretic peptide with diastolic function in hypertensive heart disease. UMass Chan Medical School Faculty Publications. https://doi.org/10.1093/ajh/hpt098. Retrieved from https://escholarship.umassmed.edu/faculty_pubs/784