title: N-terminal pro-B-type natriuretic peptide is associated with aortic stiffness in patients presenting with acute myocardial infarction.
abstract: BACKGROUND
  Aortic stiffness is associated with increased left ventricular (LV) afterload, a process which is accompanied by a release of natriuretic peptides. Aortic pulse wave velocity (PWV) has been demonstrated to be the functional surrogate of aortic stiffness. We sought to investigate the impact of aortic PWV on N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations in patients with acute myocardial infarction (AMI).
  
  
  METHODS
  This prospective observational study included 86 consecutive patients undergoing percutaneous coronary intervention for AMI. Aortic PWV was determined 47 h (interquartile range (IQR) 27-64 h) after AMI using an established oscillometric device. NT-proBNP values were measured using a commercially available immunoassay.
  
  
  RESULTS
  The mean age of the study cohort was 60±11 years; 19% were female. Median aortic PWV was 7.8 m/s (IQR 6.8-9.4 m/s). Patients with a PWV above the median showed significantly higher NT-proBNP peak concentrations (median=1330 ng/l, IQR: 729-3180 ng/l vs median=498 ng/l, IQR: 124-1575 ng/l, p=0.001). Aortic PWV (beta=0.373, p=0.014) was independently associated with NT-proBNP peak concentrations even after correction for LV function, cardiac troponin T levels, heart rate, blood pressure, body mass index and the primary prevention European Society of Cardiology (ESC) SCORE (model: R=0.542, p=0.014).
  
  
  CONCLUSIONS
  In patients with AMI, aortic PWV is independently associated with NT-proBNP concentrations. This finding suggests an impact of aortic PWV on myocardial wall stress after AMI.
authors.affiliation: University Clinic of Internal Medicine III, Medical University of Innsbruck, Austria.
authors.forename: Hans-Josef
authors.initials: HJ
authors.lastname: Feistritzer
authors.affiliation: University Clinic of Internal Medicine III, Medical University of Innsbruck, Austria.
authors.forename: Sebastian J
authors.initials: SJ
authors.lastname: Reinstadler
authors.affiliation: University Clinic of Internal Medicine III, Medical University of Innsbruck, Austria.
authors.forename: Gert
authors.initials: G
authors.lastname: Klug
authors.affiliation: Department of Radiology, Medical University of Innsbruck, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Kremser
authors.affiliation: University Clinic of Internal Medicine III, Medical University of Innsbruck, Austria.
authors.forename: Andrea
authors.initials: A
authors.lastname: Rederlechner
authors.affiliation: University Clinic of Internal Medicine III, Medical University of Innsbruck, Austria.
authors.forename: Johannes
authors.initials: J
authors.lastname: Mair
authors.affiliation: University Clinic of Internal Medicine III, Medical University of Innsbruck, Austria.
authors.forename: Silvana
authors.initials: S
authors.lastname: Müller
authors.affiliation: University Clinic of Internal Medicine III, Medical University of Innsbruck, Austria.
authors.forename: Wolfgang-Michael
authors.initials: WM
authors.lastname: Franz
authors.affiliation: University Clinic of Internal Medicine III, Medical University of Innsbruck, Austria Bernhard.Metzler@tirol-kliniken.at.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Metzler
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000378:metabolism* / Q000503:physiopathology* / Q000601:surgery; D020097:Natriuretic Peptide, Brain / Q000378:metabolism*; D010446:Peptide Fragments / Q000378:metabolism*; D062645:Percutaneous Coronary Intervention; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D059289:Vascular Stiffness / Q000502:physiology*
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Aortic stiffness; acute myocardial infarction; natriuretic peptides; pulse wave velocity