Early diagnosis of left ventricular diastolic dysfunction in diabetic patients: a possible role for natriuretic peptides

Cardiovascular Diabetology

Original Investigation

Leonello Guarracini¹  Maria Penco²  Michele Di Mauro²  Simona Fratini²  Silvio Romano²  Fabrizio Guarracini²  Gianfranco Poccia³ 

[1] Cardiac Rehabilitation, "Umberto I" Hospital, Tagliacozzo, Italy;Cardiology, Department of Internal Medicine and Public Health, University of L'Aquila, Italy;Diabetology, "San Salvatore" Hospital, L'Aquila, Italy;

关键词: Diastolic Dysfunction;    Brain Natriuretic Peptide;    Diabetic Cardiomyopathy;    Receiver Operating Characteristic Curve Analysis;    Left Ventricular Diastolic Dysfunction;   

DOI  :  10.1186/1475-2840-9-89

 received in 2010-10-19, accepted in 2010-12-16,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundThe aim of the present study was to verify whether BNP might detect pre-clinical diastolic dysfunction (LVDD) in type-2 diabetic patients.MethodsOne-hundred and twenty-seven consecutive outpatients with type-2 diabetes mellitus were enrolled into the study. Subjects with overt heart failure or NYHA class > 1, history of coronary artery disease, severe valvulopathy or chronic atrial fibrillation were excluded from the study. All patients underwent clinical evaluation, laboratory assessment of brain natriuretic peptide (BNP) and echocardiographic examination.ResultsNo patients showed systolic impairment of left ventricular function, whereas diastolic dysfunction was detected in 53 (42%) cases (all impaired relaxation). Median BNP was 27 pg/ml without any significant difference between 76 patients with normal left ventricular function and 53 with diastolic dysfunction; in 54 (43%) patients showing HBA1C≥8 (uncontrolled diabetes) normal function was found in 32 and diastolic dysfunction in 22, with a significant difference of BNP at multivariate analysis (OR = 1.02, 95%CI = 1.05-1.09, p = 0.003). In uncontrolled diabetic cohort, BNP was a strong predictor for LVDD (OR = 2.7, 95%CI = 1.3-5.6, p = 0.006) along with the duration of diabetes (OR = 1.6, 95%CI = 1.1-2.9, p = 0.046). BNP > 25 pg/ml was a cut-off value with high accuracy to detect a LVDD.DiscussionEarly screening of high-risk patients for diabetic cardiomyopathy development might be useful to better control glycemic profile in order to reduce heart disease progression or even to reverse itConclusionsBNP could be a cheap, easy and useful tool to screen those ones with preclinical ventricular diastolic dysfunction in a subset of patients particularly prone to develop cardiovascular complications, like uncontrolled diabetic patients.

【 授权许可】

CC BY   
© Romano et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.