Slightly elevated B-type natriuretic peptide levels in a non-heart failure range indicate a worse left ventricular diastolic function in individuals with, as compared with individuals without, type 2 diabetes: the Hoorn Study
Slightly elevated B-type natriuretic peptide levels in a non-heart failure range indicate a worse left ventricular diastolic function in individuals with, as compared with individuals without, type 2 diabetes: the Hoorn Study
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DOI：
10.1093/eurjhf/hfq119
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发表时间：
2010-09-01
影响因子：
18.2
通讯作者：
Dekker, Jacqueline M.
中科院分区：
文献类型：
--
作者：
van den Hurk, Katja;Alssema, Marjan;Dekker, Jacqueline M.
在一般人群中，非心力衰竭（HF）范围内较高的血浆B型利钠肽（BNP）可预测HF和心血管疾病（CVD）死亡率。心力衰竭在2型糖尿病（T2 DM）中非常普遍，但BNP与不同血糖状态个体的左心室（LV）质量和功能的相关性尚未进行比较。因此，我们的目的是探讨（i）BNP水平在非HF范围内与LV功能的结构和功能标志物的相关性，以及（ii）葡萄糖耐量类别可能的效果修饰。方法和结果进行线性回归分析，以调查BNP与LV质量指数，LV收缩功能，在一项基于人群的研究中，对糖代谢正常（NGM，n = 197）、糖代谢受损（IGM，n = 28）或T2 DM（n =04）的男性和女性进行了LV舒张功能标记物。患者年龄在50 - 87岁之间，BNP水平低于50 pmol/L，无左室壁运动异常。B型利钠肽水平范围为0.4 - 46.1 pmol/L，中位数为4.2 pmol/L。BNP升高与左室重量增加和左室舒张功能恶化显著相关，但与左室收缩功能无关。结论B型利钠肽与T2 DM患者的左室质量和左室舒张功能指标相关，其中BNP与左室舒张功能指标的相关性在T2 DM患者中尤为明显。这意味着如果使用BNP水平评估CVD风险，则应考虑是否存在T2 DM。
Aims Higher plasma B-type natriuretic peptide (BNP) in a non-heart failure (HF) range predicts HF and cardiovascular disease (CVD) mortality in the general population. Heart failure is highly prevalent in type 2 diabetes mellitus (T2DM), but associations of BNP to left ventricular (LV) mass and function in individuals with a different glucose status have not been compared. We therefore aimed to explore (i) the association of BNP levels in a non-HF range with structural and functional markers of LV function, and (ii) possible effect modification by glucose tolerance categories.Methods and results Linear regression analyses were performed to investigate associations of BNP with 2D echocardiographic measures of LV mass index, LV systolic function, and markers of LV diastolic function in a population-based study of men and women with normal glucose metabolism (NGM, n = 197), impaired glucose metabolism (IGM, n = 28), or T2DM (n =04). Patients were aged between 50 and 87 years, had BNP levels below 50 pmol/L, and no LV wall motion abnormalities. B-type natriuretic peptide levels ranged from 0.4 to 46.1 pmol/L, the median was 4.2 pmol/L. Higher BNP was significantly associated with increased LV mass and deteriorated LV diastolic function, but not with LV systolic function. B-type natriuretic peptide was more strongly associated with LV diastolic function in T2DM compared with NGM and IGM.Conclusion B-type natriuretic peptide was associated with LV mass and markers of LV diastolic function, and the association of BNP with the latter appeared to be particularly strong in individuals with T2DM. This implies that the presence or absence of T2DM should be taken into account if BNP levels are used to assess CVD risk.