Relation of N-terminal pro-B-type natriuretic peptide with diastolic function in hypertensive heart disease
Department of Medicine, Division of Cardiovascular Medicine
Aged; Diastole; Echocardiography; Female; Humans; Hypertension; Male; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; Ventricular Dysfunction, Left
Cardiology | Cardiovascular Diseases
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
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
American journal of hypertension
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. University of Massachusetts Medical School Faculty Publications. https://doi.org/10.1093/ajh/hpt098. Retrieved from https://escholarship.umassmed.edu/faculty_pubs/784