TY - JOUR
T1 - Relation of N-terminal Pro-B-Type natriuretic peptide with diastolic function in hypertensive heart disease
AU - Uraizee, Imran
AU - Cheng, Susan
AU - Hung, Chung Lieh
AU - Verma, Anil
AU - Thomas, James D.
AU - Zile, Michael R.
AU - Aurigemma, Gerard P.
AU - Solomon, Scott D.
N1 - Funding Information:
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).
Funding Information:
The original clinical trial was funded by Novartis Pharmaceuticals.
PY - 2013/10
Y1 - 2013/10
N2 - 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.
AB - 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.
KW - blood pressure
KW - diastolic function
KW - hypertension
KW - imaging
KW - natriuretic peptides
KW - speckle-tracking echocardiography
KW - strain
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U2 - 10.1093/ajh/hpt098
DO - 10.1093/ajh/hpt098
M3 - Article
C2 - 23792241
AN - SCOPUS:84890056228
SN - 0895-7061
VL - 26
SP - 1234
EP - 1241
JO - American Journal of Hypertension
JF - American Journal of Hypertension
IS - 10
ER -