Relation of N-terminal Pro-B-Type natriuretic peptide with diastolic function in hypertensive heart disease

Imran Uraizee, Susan Cheng, Chung Lieh Hung, Anil Verma, James D. Thomas, Michael R. Zile, Gerard P. Aurigemma, Scott D. Solomon*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


BACKGROUNDElevated natriuretic peptide levels in asymptomatic individuals without heart failure are associated with increased risk of adverse cardiovascular outcomes and may reflect subclinical cardiac dysfunction. METHODSIn 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.RESULTSIn 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).CONCLUSIONSIn the setting of asymptomatic hypertensive heart disease and preserved ejection fraction, elevation in natriuretic peptide levels is predominantly associated with subclinical diastolic dysfunction.

Original languageEnglish (US)
Pages (from-to)1234-1241
Number of pages8
JournalAmerican Journal of Hypertension
Issue number10
StatePublished - Oct 2013


  • blood pressure
  • diastolic function
  • hypertension
  • imaging
  • natriuretic peptides
  • speckle-tracking echocardiography
  • strain

ASJC Scopus subject areas

  • Internal Medicine


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