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November 27, 2024Biomedicines4 citationsOpen Access

The Implication of NT-proBNP in the Assessment of the Clinical Phenotype of Patients with Type 2 Diabetes Mellitus, Without Established Cardiovascular Disease

IGIoannis GastouniotisCFChristos FragoulisAAAlexios S. Antonopoulos

Key Result

In T2DM patients without known CVD, higher NT-proBNP levels (>107 pg/mL) were associated with lower predicted maximum oxygen consumption compared to lower levels (84% vs. 92%, p=0.018).

Study Design

Type

Cross-Sectional (n=100)

Structured PICO

Do elevated NT-proBNP levels correlate with impaired functional capacity and imaging indices of heart failure in T2DM patients without established cardiovascular disease?

P
Population
100 consecutive patients with type 2 diabetes mellitus (T2DM) without known cardiovascular disease, mean age 67 ± 9 years, 40% women and 60% men.
I
Intervention
Highest tertile of NT-proBNP values (>107 pg/mL)
C
Comparator
Lowest quartile of NT-proBNP values (<55 pg/mL)
O
Outcome
Phenotypical, functional characteristics (CPET) and imaging parameters (echocardiography and CMR)surrogate

Elevated NT-proBNP levels in T2DM patients without established CVD correlate with subclinical functional and imaging indices of HFpEF.

Main Result

Absolute Event Rate: 84% vs 92%

p-value: p=0.018

Abstract

Background: Natriuretic peptide (NP) levels have been proposed for characterization and risk stratification of heart failure (HF) among patients with cardiovascular disease (CVD). However, their role in patients with diabetes mellitus type 2 (T2DM) has not been well studied and understood. The aim of this study was to assess phenotypical, functional characteristics and imaging parameters in relation to N-terminal pro b-type natriuretic peptide (NT-proBNP) values in T2DM patients without known CVD that may predispose to overt HF. Methods: This was a cross-sectional study of 100 consecutive T2DM patients (mean overall age of 67 ± 9 years, 40% women and 60% men) who were enrolled from the outpatient diabetic clinic. Patients underwent a cardiopulmonary exercise test (CPET), and echocardiographic and cardiac magnetic resonance imaging (CMR); serum NT-proBNP was also measured. Results: The mean (standard deviation) NT-proBNP was 149 (±186) pg/mL. Patients in the highest tertile of NT-proBNP values (>107 pg/mL) had lower values of predicted maximum oxygen consumption compared to the lowest quartile (<55 pg/mL) (84% vs. 92%, p = 0.018) in the CPET and higher ratio of early diastolic mitral inflow velocity to early diastolic mitral annulus velocity (E/e′) (9.0 vs. 7.2, p = 0.05) in echocardiography. Finally, there was a negative correlation between right ventricle end diastolic volume in CMR and predicted maximum oxygen consumption (b = −0.225 ± 0.11, p = 0.046). Conclusions: NT-proBNP levels seemed to be a useful marker in people with T2DM, as elevated levels reflected ongoing appearance of HF with preserved ejection fraction and were related to CPET and echocardiographic indices of impaired left ventricular diastolic and right ventricular systolic function.

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Cite This Study

Gastouniotis et al. (2024) conducted a cross-sectional in Type 2 Diabetes Mellitus without established cardiovascular disease (n=100). NT-proBNP levels (highest tertile >107 pg/mL) vs. Lowest quartile (<55 pg/mL) was evaluated on Predicted maximum oxygen consumption in CPET (p=0.018). In T2DM patients without known CVD, higher NT-proBNP levels (>107 pg/mL) were associated with lower predicted maximum oxygen consumption compared to lower levels (84% vs. 92%, p=0.018).

synapsesocial.com/papers/6a0ebdafb9cfc04f9247a55dhttps://doi.org/10.3390/biomedicines12122718
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