title: Relation of N-terminal pro-B-type natriuretic peptide with diastolic function in hypertensive heart disease.
abstract: BACKGROUND
  Elevated natriuretic peptide levels in asymptomatic individuals without heart failure are associated with increased risk of adverse cardiovascular outcomes and may reflect subclinical cardiac dysfunction.
  
  
  METHODS
  In a sample of 313 asymptomatic individuals (51% women, mean age 61 years) with hypertension and diastolic dysfunction, we examined the association of plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) with both conventional and advanced echocardiographic measures of systolic and diastolic function, including myocardial strain, using speckle-tracking-based analyses.
  
  
  RESULTS
  In univariate analyses, higher NT-proBNP was associated with greater left ventricular mass index (P = 0.003), left atrial volume index (P = 0.007), lateral E' velocity (P < 0.0001), E/E' ratio (P < 0.0001), peak global longitudinal systolic strain (P = 0.015), systolic strain rate (P = 0.021), and early diastolic strain rate (P < 0.0001). In multivariable analyses, NT-proBNP remained associated with measures of diastolic dysfunction, including lateral E' velocity (P = 0.013) and the E/E' ratio (P = 0.008). However, early diastolic strain rate was the echocardiographic parameter most strongly associated with NT-proBNP (P = 0.003).
  
  
  CONCLUSIONS
  In the setting of asymptomatic hypertensive heart disease and preserved ejection fraction, elevation in natriuretic peptide levels is predominantly associated with subclinical diastolic dysfunction.
authors.affiliation: Brigham and Women's Hospital, Cardiovascular Division, Boston, MA.
authors.forename: Imran
authors.initials: I
authors.lastname: Uraizee
authors.forename: Susan
authors.initials: S
authors.lastname: Cheng
authors.forename: Chung-Lieh
authors.initials: CL
authors.lastname: Hung
authors.forename: Anil
authors.initials: A
authors.lastname: Verma
authors.forename: James D
authors.initials: JD
authors.lastname: Thomas
authors.forename: Michael R
authors.initials: MR
authors.lastname: Zile
authors.forename: Gerard P
authors.initials: GP
authors.lastname: Aurigemma
authors.forename: Scott D
authors.initials: SD
authors.lastname: Solomon
mesh_terms: D000368:Aged; D003971:Diastole; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000000981:diagnostic imaging*
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: blood pressure; diastolic function; hypertension; imaging; natriuretic peptides; speckle-tracking echocardiography; strain.