Plasma NT-proBNP concentration is related to ambulatory pulse pressure in peripheral arterial disease.
BACKGROUND
Increased levels of N-terminal prohormone brain natriuretic peptide (NT-proBNP) are associated with left ventricular dysfunction (LVD) and left ventricular hypertrophy (LVH), but the relation of NT-proBNP to ambulatory blood pressure (ABP) and hypertensive target organ damage in high-risk patients with peripheral arterial disease (PAD) has not been studied. We hypothesized that NT-proBNP levels were increased in patients with PAD in comparison to a matched control group and that levels of NT-proBNP were related to ABP.


METHODS
Blood samples were analysed for NT-proBNP in 103 males with PAD and 96 age- and sex-matched controls. Ninety-eight PAD patients performed ABP monitoring and 99 underwent Tc-99m Sestamibi myocardial perfusion SPECT.


RESULTS
NT-proBNP was significantly increased in PAD patients compared with controls [median (interquartiles)] 167(76, 418) vs 68(38, 142) pg/ml, p<0.001. Plasma levels of NT-proBNP correlated positively to systolic blood pressure (SBP), pulse pressure (PP), night-day ratio of SBP and showed the strongest correlation to average night PP (r=0.42, p<0.001). In multiple regression analysis, night PP remained independently related to NT-proBNP.


CONCLUSIONS
NT-proBNP levels are markedly increased in PAD patients compared to age-matched controls. Night PP is related to NT-proBNP levels independently of other variables highlighting the importance of ambulatory PP as a cardiovascular risk factor. Measurement of NT-proBNP could be indicated in PAD patients for further risk stratification.
Svensson
Per
P
Department of Medecine, Division of Emergency Medecine, Karolinska Institute Stockholm, Sweden. per.svensson@karolinska.se
de Faire
Ulf
U
Niklasson
Urban
U
Hansson
Lars-Olof
LO
Ostergren
Jan
J
D000368:Aged; D001158:Arteries / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology*; D004562:Electrocardiography; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain; D009419:Nerve Tissue Proteins / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D014652:Vascular Diseases / Q000097:blood* / Q000000981:diagnostic imaging / Q000503:physiopathology*
D009419:Nerve Tissue Proteins; D010446:Peptide Fragments; D019275:Radiopharmaceuticals; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D017256:Technetium Tc 99m Sestamibi