B-type natriuretic Peptide is associated with both augmentation index and left ventricular mass in diabetic patients without heart failure.
BACKGROUND
B-type natriuretic peptide (BNP) increases the risk of death and cardiovascular events in patients without heart failure, even at BNP values within the "normal" range. The reasons for this are unclear.


METHODS
We performed two separate studies (n = 33 and n = 129) on subjects with type 2 diabetes mellitus in whom frank left ventricular systolic dysfunction had been excluded to ascertain whether a high-normal BNP could be identifying either greater augmentation of the ascending aortic pressure wave, increased left ventricular mass, or a subtly lower left ventricular ejection fraction (but within the normal range).


RESULTS
Our results demonstrate that an increased augmentation index is an independent predictor of BNP levels even when BNP levels are within the normal range (P = .006 in study one and P = .007 in study two). A high-normal BNP also correlated with increased left ventricular mass and (P = .021) with a subtly lower left ventricular ejection fraction (P < .001).


CONCLUSIONS
We found that high-normal BNP levels identified increased augmentation of the ascending aortic pressure wave as well as subtle left ventricular abnormalities.
Dawson
Adelle
A
Division of Medicine & Therapeutics, University of Dundee, Ninewells Hospital & Medical School, Dundee, Scotland, United Kingdom.
Davies
Justine I
JI
Morris
Andrew D
AD
Struthers
Allan D
AD
D000368:Aged; D001011:Aorta / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000503:physiopathology; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000097:blood* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D013318:Stroke Volume; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000000981:diagnostic imaging
D020097:Natriuretic Peptide, Brain