Abstract
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 language | English (US) |
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Pages (from-to) | 1234-1241 |
Number of pages | 8 |
Journal | American Journal of Hypertension |
Volume | 26 |
Issue number | 10 |
DOIs | |
State | Published - Oct 2013 |
Funding
I.U. was a research fellow supported by the Sarnoff Cardiovascular Research Foundation. S.C. is supported by the Ellison Foundation and National Heart, Lung, and Blood Institute (grantK99Hl107642). The original clinical trial was funded by Novartis Pharmaceuticals.
Keywords
- blood pressure
- diastolic function
- hypertension
- imaging
- natriuretic peptides
- speckle-tracking echocardiography
- strain
ASJC Scopus subject areas
- Internal Medicine