title: N-Terminal Pro-B-Type Natriuretic Peptide and Subclinical Brain Damage in the General Population.
abstract: Purpose To investigate the association between N-terminal pro-B-type natriuretic peptide (NT-proBNP), which is a marker of heart disease, and markers of subclinical brain damage on magnetic resonance (MR) images in community-dwelling middle-aged and elderly subjects without dementia and without a clinical diagnosis of heart disease. Materials and Methods This prospective population-based cohort study was approved by a medical ethics committee overseen by the national government, and all participants gave written informed consent. Serum levels of NT-proBNP were measured in 2397 participants without dementia or stroke (mean age, 56.6 years; age range, 45.7-87.3 years) and without clinical diagnosis of heart disease who were drawn from the population-based Rotterdam Study. All participants were examined with a 1.5-T MR imager. Multivariable linear and logistic regression analyses were used to investigate the association between NT-proBNP level and MR imaging markers of subclinical brain damage, including volumetric, focal, and microstructural markers. Results A higher NT-proBNP level was associated with smaller total brain volume (mean difference in z score per standard deviation increase in NT-proBNP level, -0.021; 95% confidence interval [CI]: -0.034, -0.007; P = .003) and was predominantly driven by gray matter volume (mean difference in z score per standard deviation increase in NT-proBNP level, -0.037; 95% CI: -0.057, -0.017; P < .001). Higher NT-proBNP level was associated with larger white matter lesion volume (mean difference in z score per standard deviation increase in NT-proBNP level, 0.090; 95% CI: 0.051, 0.129; P < .001), with lower fractional anisotropy (mean difference in z score per standard deviation increase in NT-proBNP level, -0.048; 95% CI: -0.088, -0.008; P = .019) and higher mean diffusivity (mean difference in z score per standard deviation increase in NT-proBNP level, 0.054; 95% CI: 0.018, 0.091; P = .004) of normal-appearing white matter. Conclusion In community-dwelling persons, higher serum NT-proBNP levels are associated with volumetric and microstructural MR imaging markers of subclinical brain damage.©RSNA, 2016 Online supplemental material is available for this article.
authors.affiliation: From the Departments of Epidemiology (H.I.Z., M.A.I., A.H., O.H.F., M.W.V.), Radiology and Nuclear Medicine (H.I.Z., M.A.I., W.J.N., A.v.d.L., G.P.K., M.W.V.), Neurology (M.A.I.), and Medical Informatics (W.J.N.), Erasmus MC, University Medical Center Rotterdam, Room Na28-18, PO Box 2040, 3000 CA Rotterdam, the Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Mass (A.H.); and Department of Imaging Physics, Faculty of Applied Sciences, Delft University of Technology, Delft, the Netherlands (W.J.N.).
authors.forename: Hazel I
authors.initials: HI
authors.lastname: Zonneveld
authors.affiliation: From the Departments of Epidemiology (H.I.Z., M.A.I., A.H., O.H.F., M.W.V.), Radiology and Nuclear Medicine (H.I.Z., M.A.I., W.J.N., A.v.d.L., G.P.K., M.W.V.), Neurology (M.A.I.), and Medical Informatics (W.J.N.), Erasmus MC, University Medical Center Rotterdam, Room Na28-18, PO Box 2040, 3000 CA Rotterdam, the Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Mass (A.H.); and Department of Imaging Physics, Faculty of Applied Sciences, Delft University of Technology, Delft, the Netherlands (W.J.N.).
authors.forename: M Arfan
authors.initials: MA
authors.lastname: Ikram
authors.affiliation: From the Departments of Epidemiology (H.I.Z., M.A.I., A.H., O.H.F., M.W.V.), Radiology and Nuclear Medicine (H.I.Z., M.A.I., W.J.N., A.v.d.L., G.P.K., M.W.V.), Neurology (M.A.I.), and Medical Informatics (W.J.N.), Erasmus MC, University Medical Center Rotterdam, Room Na28-18, PO Box 2040, 3000 CA Rotterdam, the Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Mass (A.H.); and Department of Imaging Physics, Faculty of Applied Sciences, Delft University of Technology, Delft, the Netherlands (W.J.N.).
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.affiliation: From the Departments of Epidemiology (H.I.Z., M.A.I., A.H., O.H.F., M.W.V.), Radiology and Nuclear Medicine (H.I.Z., M.A.I., W.J.N., A.v.d.L., G.P.K., M.W.V.), Neurology (M.A.I.), and Medical Informatics (W.J.N.), Erasmus MC, University Medical Center Rotterdam, Room Na28-18, PO Box 2040, 3000 CA Rotterdam, the Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Mass (A.H.); and Department of Imaging Physics, Faculty of Applied Sciences, Delft University of Technology, Delft, the Netherlands (W.J.N.).
authors.forename: Wiro J
authors.initials: WJ
authors.lastname: Niessen
authors.affiliation: From the Departments of Epidemiology (H.I.Z., M.A.I., A.H., O.H.F., M.W.V.), Radiology and Nuclear Medicine (H.I.Z., M.A.I., W.J.N., A.v.d.L., G.P.K., M.W.V.), Neurology (M.A.I.), and Medical Informatics (W.J.N.), Erasmus MC, University Medical Center Rotterdam, Room Na28-18, PO Box 2040, 3000 CA Rotterdam, the Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Mass (A.H.); and Department of Imaging Physics, Faculty of Applied Sciences, Delft University of Technology, Delft, the Netherlands (W.J.N.).
authors.forename: Aad
authors.initials: A
authors.lastname: van der Lugt
authors.affiliation: From the Departments of Epidemiology (H.I.Z., M.A.I., A.H., O.H.F., M.W.V.), Radiology and Nuclear Medicine (H.I.Z., M.A.I., W.J.N., A.v.d.L., G.P.K., M.W.V.), Neurology (M.A.I.), and Medical Informatics (W.J.N.), Erasmus MC, University Medical Center Rotterdam, Room Na28-18, PO Box 2040, 3000 CA Rotterdam, the Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Mass (A.H.); and Department of Imaging Physics, Faculty of Applied Sciences, Delft University of Technology, Delft, the Netherlands (W.J.N.).
authors.forename: Gabriel P
authors.initials: GP
authors.lastname: Krestin
authors.affiliation: From the Departments of Epidemiology (H.I.Z., M.A.I., A.H., O.H.F., M.W.V.), Radiology and Nuclear Medicine (H.I.Z., M.A.I., W.J.N., A.v.d.L., G.P.K., M.W.V.), Neurology (M.A.I.), and Medical Informatics (W.J.N.), Erasmus MC, University Medical Center Rotterdam, Room Na28-18, PO Box 2040, 3000 CA Rotterdam, the Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Mass (A.H.); and Department of Imaging Physics, Faculty of Applied Sciences, Delft University of Technology, Delft, the Netherlands (W.J.N.).
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Franco
authors.affiliation: From the Departments of Epidemiology (H.I.Z., M.A.I., A.H., O.H.F., M.W.V.), Radiology and Nuclear Medicine (H.I.Z., M.A.I., W.J.N., A.v.d.L., G.P.K., M.W.V.), Neurology (M.A.I.), and Medical Informatics (W.J.N.), Erasmus MC, University Medical Center Rotterdam, Room Na28-18, PO Box 2040, 3000 CA Rotterdam, the Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Mass (A.H.); and Department of Imaging Physics, Faculty of Applied Sciences, Delft University of Technology, Delft, the Netherlands (W.J.N.).
authors.forename: Meike W
authors.initials: MW
authors.lastname: Vernooij
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009426:Netherlands; D010446:Peptide Fragments / Q000097:blood*; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain