Key result
Elevated central SBP strongly correlates with higher NT-proBNP in diabetic men without LV dysfunction.
Why the study?
In diabetes, left ventricular dysfunction independent of coronary disease is common and associated with elevations in NT-proBNP, but the relative importance of central aortic pressure, autonomic function, and arterial stiffness as predictors is unclear.
Cross-Sectional (n=71)
No
Effect estimate: beta = 0.67
p-value: p=<0.0001
Elevated central arterial pressure is a strong predictor of NT-proBNP concentrations in diabetic men without clinically apparent left ventricular dysfunction.
Central SBP monitoring should not yet guide care in diabetic men; leaves open causal links to subclinical cardiac strain.
Background: In diabetes, left ventricular dysfunction independent of coronary disease is common and is associated with elevations in NT-proBNP.Our aims were to determine the relative importance of central aortic pressure, cardiovascular autonomic function and arterial stiffness as predictors of elevated NT-proBNP.Methods: Fifty males with diabetes mellitus and 21 males with IGT were studied.Arterial stiffness and wave reflections were assessed by measuring aortic and brachial pulse wave velocity (PWV) and augmentation index (AIX).Cardiovascular autonomic function was assessed by measurements of heart rate variability following standard manoeuvres.Results: Comparing diabetes versus IGT subjects (mean Æ SD), both aortic PWV (9.7 Æ 2.4 versus 8.2 Æ 1.4 m/s, p < 0.01) and cardiovascular autonomic dysfunction (autonomic score 2.3 Æ 1.3 versus 1.6 Æ 1.0, p < 0.01) were greater in diabetes subjects.NT-proBNP levels correlated with central and brachial systolic pressure (r Z 0.74, p < 0.0001 and r Z 0.66, p < 0.0001, respectively), aortic PWV (r Z 0.43, p < 0.01), AIX (r Z 0.55, p < 0.0001), and autonomic function (r Z 0.37, p < 0.01).Multiple regression analysis amongst diabetic subjects showed central systolic blood pressure to be the strongest predictor of NT-proBNP concentrations.Conclusions: Elevated central arterial pressure is a strong predictor of NT-proBNP concentrations in diabetic men without clinically apparent left ventricular dysfunction.This is indicative
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Bunce et al. (2008) conducted a cross-sectional in Diabetes mellitus and impaired glucose tolerance (n=71). Central arterial pressure and autonomic dysfunction was evaluated on Predictors of log NT-proBNP concentrations in diabetic subjects (beta = 0.67, p=<0.0001). Elevated central systolic blood pressure is a strong independent predictor of NT-proBNP concentrations in diabetic men without clinically apparent left ventricular dysfunction (beta = 0.67, p < 0.0001).
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