NT-proBNP, echocardiographic abnormalities and subclinical coronary artery disease in high risk type 2 diabetic patients

Cardiovascular Diabetology

Original Investigation

Peter R Hansen¹  Kaj Winther²  Niels Wiinberg³  Claus L Petersen³  Andreas Kjær⁴  Hans-Henrik Parving⁵  Henrik Reinhard⁶  Peter Rossing⁶  Peter K Jacobsen⁷ 

[1] Department of Cardiology, Gentofte University Hospital, Gentofte, Denmark;Department of Clinical Biochemistry, Frederiksberg University Hospital, Frederiksberg, Denmark;Department of Clinical Physiology and Nuclear Medicine, Frederiksberg University Hospital, Frederiksberg, Denmark;Department of Clinical Physiology and Nuclear Medicine, Frederiksberg University Hospital, Frederiksberg, Denmark;Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark;Department of Medical Endocrinology, University Hospital of Copenhagen, Copenhagen, Denmark;Faculty of Health Science, Aarhus University, Aarhus, Denmark;Steno Diabetes Center, Niels Steensenvej 1, 2820, DK, Gentofte, Denmark;Steno Diabetes Center, Niels Steensenvej 1, 2820, DK, Gentofte, Denmark;The Heart Centre, Rigshospitalet, Copenhagen, Denmark;

关键词: Myocardial Perfusion Image;    Left Ventricular Hypertrophy;    Diastolic Dysfunction;    Left Atrial;    Left Ventricular Mass;   

DOI  :  10.1186/1475-2840-11-19

 received in 2012-01-03, accepted in 2012-03-05,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundIntensive multifactorial treatment aimed at prevention of cardiovascular (CV) disease may reduce left ventricular (LV) echocardiographic abnormalities in diabetic subjects. Plasma N-terminal (NT)-proBNP predicts CV mortality in diabetic patients but the association between P-NT-proBNP and the putative residual abnormalities in such patients are not well described. This study examined echocardiographic measurements of LV hypertrophy, atrial dilatation and LV dysfunction and their relation to P-NT-proBNP levels or subclinical coronary artery disease (CAD) in type 2 diabetic patients with microalbuminuria receiving intensive multifactorial treatment.MethodsEchocardiography including tissue Doppler imaging and P-NT-proBNP measurements were performed in 200 patients without prior CAD. Patients with P-NT-proBNP > 45.2 ng/L and/or coronary calcium score ≥ 400 were stratified as high risk patients for CAD(n = 133) and examined for significant CAD by myocardial perfusion imaging and/or CT-angiography and/or coronary angiography.ResultsLV mass index was 41.2 ± 10.9 g/m2.7 and 48 (24%) patients had LV hypertrophy. LA and RA dilatation were found in 54(27%) and 45(23%) patients, respectively, and LV diastolic dysfunction was found in 109(55%) patients. Patients with increased P-NT-proBNP levels did not have more major echocardiographic abnormalities. In 70(53%) of 133 high risk patients significant CAD was demonstrated and patients with LV hypertrophy had increased risk of significant CAD(adjusted odd ratio[CI] was 4.53[1.14-18.06]).ConclusionAmong asymptomatic type 2 diabetic patients with microalbuminuria that received intensive multifactorial treatment, P-NT-proBNP levels is not associated with echocardiographic abnormalities. LV diastolic dysfunction was frequently observed, whereas LV hypertrophy was less frequent but associated with significant CAD.

【 授权许可】

CC BY   
© Reinhard et al; licensee BioMed Central Ltd. 2012