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Am J Hypertens. 2013 Oct;26(10):1234-41. doi: 10.1093/ajh/hpt098. Epub 2013 Jun 22.

Relation of N-terminal pro-B-type natriuretic peptide with diastolic function in hypertensive heart disease.

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  • 1Brigham and Women's Hospital, Cardiovascular Division, Boston, MA.

Abstract

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.

KEYWORDS:

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

PMID:
23792241
[PubMed - indexed for MEDLINE]
PMCID:
PMC3773573
Free PMC Article
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