title: N-terminal pro-brain natriuretic peptide and subclinical brain small vessel disease.
abstract: OBJECTIVE
  To study the association of N-terminal pro-brain natriuretic peptide (NT-proBNP) with several brain MRI markers of brain vascular disease in a sample of participants free of stroke and dementia.
  
  
  METHODS
  NT-proBNP plasma level was determined by means of a sandwich immunoassay method in a cohort study comprising 278 hypertensive patients. The presence of silent brain infarcts, brain microbleeds, enlarged perivascular spaces, and white matter hyperintensity volumes was assessed by brain MRI. We performed univariate and multivariate analyses to determine whether NT-proBNP was independently associated with these imaging markers, individually or combined.
  
  
  RESULTS
  Median age was 63 years, and 41.4% were women. NT-proBNP remained independently associated with silent brain infarcts (odds ratio [OR] per 1-SD increase in NT-proBNP 2.11, 95% confidence interval [CI] 1.44-3.10), brain microbleeds (OR 1.79, 95% CI 1.15-2.78), basal ganglia enlarged perivascular spaces (OR 1.55, 95% CI 1.12-2.15), and white matter hyperintensity volumes (β 1.60, 95% CI 0.47-2.74), even after controlling for vascular risk factors, cardiovascular risk, atrial fibrillation, previous heart disease, duration of hypertension, and preventive treatments. A score combining several imaging markers was also related to NT-proBNP levels (common OR per 1-SD increase 1.74, 95% CI 1.21-2.50).
  
  
  CONCLUSIONS
  NT-proBNP is independently associated with silent cerebrovascular lesions and could be a surrogate marker of vascular brain damage in hypertension.
authors.affiliation: From the Neurovascular Research Laboratory (A.V.-B., I.R.-L., A.P., J.J.-B., J.M., P.D.), Vall d'Hebron Research Institute, Department of Medicine, Universitat Autònoma de Barcelona; Stroke Unit (J.M.), Neurology Department, Vall d'Hebron Hospital; and Clinical Biochemistry Unit (L.M.C.), Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: Andrea
authors.initials: A
authors.lastname: Vilar-Bergua
authors.affiliation: From the Neurovascular Research Laboratory (A.V.-B., I.R.-L., A.P., J.J.-B., J.M., P.D.), Vall d'Hebron Research Institute, Department of Medicine, Universitat Autònoma de Barcelona; Stroke Unit (J.M.), Neurology Department, Vall d'Hebron Hospital; and Clinical Biochemistry Unit (L.M.C.), Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: Iolanda
authors.initials: I
authors.lastname: Riba-Llena
authors.affiliation: From the Neurovascular Research Laboratory (A.V.-B., I.R.-L., A.P., J.J.-B., J.M., P.D.), Vall d'Hebron Research Institute, Department of Medicine, Universitat Autònoma de Barcelona; Stroke Unit (J.M.), Neurology Department, Vall d'Hebron Hospital; and Clinical Biochemistry Unit (L.M.C.), Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: Penalba
authors.affiliation: From the Neurovascular Research Laboratory (A.V.-B., I.R.-L., A.P., J.J.-B., J.M., P.D.), Vall d'Hebron Research Institute, Department of Medicine, Universitat Autònoma de Barcelona; Stroke Unit (J.M.), Neurology Department, Vall d'Hebron Hospital; and Clinical Biochemistry Unit (L.M.C.), Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: Luz María
authors.initials: LM
authors.lastname: Cruz
authors.affiliation: From the Neurovascular Research Laboratory (A.V.-B., I.R.-L., A.P., J.J.-B., J.M., P.D.), Vall d'Hebron Research Institute, Department of Medicine, Universitat Autònoma de Barcelona; Stroke Unit (J.M.), Neurology Department, Vall d'Hebron Hospital; and Clinical Biochemistry Unit (L.M.C.), Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Jiménez-Balado
authors.affiliation: From the Neurovascular Research Laboratory (A.V.-B., I.R.-L., A.P., J.J.-B., J.M., P.D.), Vall d'Hebron Research Institute, Department of Medicine, Universitat Autònoma de Barcelona; Stroke Unit (J.M.), Neurology Department, Vall d'Hebron Hospital; and Clinical Biochemistry Unit (L.M.C.), Hospital Universitari Vall d'Hebron, Barcelona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Montaner
authors.affiliation: From the Neurovascular Research Laboratory (A.V.-B., I.R.-L., A.P., J.J.-B., J.M., P.D.), Vall d'Hebron Research Institute, Department of Medicine, Universitat Autònoma de Barcelona; Stroke Unit (J.M.), Neurology Department, Vall d'Hebron Hospital; and Clinical Biochemistry Unit (L.M.C.), Hospital Universitari Vall d'Hebron, Barcelona, Spain. pilar.delgado@vhir.org.
authors.forename: Pilar
authors.initials: P
authors.lastname: Delgado
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002561:Cerebrovascular Disorders / Q000097:blood / Q000175:diagnosis*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain