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NT-proBNP, echocardiographic abnormalities and subclinical coronary artery disease in high risk type 2 diabetic patients

BACKGROUND: Intensive multifactorial treatment aimed at prevention of cardiovascular (CV) disease may reduce left ventricular (LV) echocardiographic abnormalities in diabetic subjects. Plasma N-terminal (NT)-proBNP predicts CV mortality in diabetic patients but the association between P-NT-proBNP an...

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Autores principales: Reinhard, Henrik, Hansen, Peter R, Wiinberg, Niels, Kjær, Andreas, Petersen, Claus L, Winther, Kaj, Parving, Hans-Henrik, Rossing, Peter, Jacobsen, Peter K
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3310741/
https://www.ncbi.nlm.nih.gov/pubmed/22390472
http://dx.doi.org/10.1186/1475-2840-11-19
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author Reinhard, Henrik
Hansen, Peter R
Wiinberg, Niels
Kjær, Andreas
Petersen, Claus L
Winther, Kaj
Parving, Hans-Henrik
Rossing, Peter
Jacobsen, Peter K
author_facet Reinhard, Henrik
Hansen, Peter R
Wiinberg, Niels
Kjær, Andreas
Petersen, Claus L
Winther, Kaj
Parving, Hans-Henrik
Rossing, Peter
Jacobsen, Peter K
author_sort Reinhard, Henrik
collection PubMed
description BACKGROUND: Intensive multifactorial treatment aimed at prevention of cardiovascular (CV) disease may reduce left ventricular (LV) echocardiographic abnormalities in diabetic subjects. Plasma N-terminal (NT)-proBNP predicts CV mortality in diabetic patients but the association between P-NT-proBNP and the putative residual abnormalities in such patients are not well described. This study examined echocardiographic measurements of LV hypertrophy, atrial dilatation and LV dysfunction and their relation to P-NT-proBNP levels or subclinical coronary artery disease (CAD) in type 2 diabetic patients with microalbuminuria receiving intensive multifactorial treatment. METHODS: Echocardiography including tissue Doppler imaging and P-NT-proBNP measurements were performed in 200 patients without prior CAD. Patients with P-NT-proBNP > 45.2 ng/L and/or coronary calcium score ≥ 400 were stratified as high risk patients for CAD(n = 133) and examined for significant CAD by myocardial perfusion imaging and/or CT-angiography and/or coronary angiography. RESULTS: LV mass index was 41.2 ± 10.9 g/m(2.7 )and 48 (24%) patients had LV hypertrophy. LA and RA dilatation were found in 54(27%) and 45(23%) patients, respectively, and LV diastolic dysfunction was found in 109(55%) patients. Patients with increased P-NT-proBNP levels did not have more major echocardiographic abnormalities. In 70(53%) of 133 high risk patients significant CAD was demonstrated and patients with LV hypertrophy had increased risk of significant CAD(adjusted odd ratio[CI] was 4.53[1.14-18.06]). CONCLUSION: Among asymptomatic type 2 diabetic patients with microalbuminuria that received intensive multifactorial treatment, P-NT-proBNP levels is not associated with echocardiographic abnormalities. LV diastolic dysfunction was frequently observed, whereas LV hypertrophy was less frequent but associated with significant CAD.
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spelling pubmed-33107412012-03-23 NT-proBNP, echocardiographic abnormalities and subclinical coronary artery disease in high risk type 2 diabetic patients Reinhard, Henrik Hansen, Peter R Wiinberg, Niels Kjær, Andreas Petersen, Claus L Winther, Kaj Parving, Hans-Henrik Rossing, Peter Jacobsen, Peter K Cardiovasc Diabetol Original Investigation BACKGROUND: Intensive multifactorial treatment aimed at prevention of cardiovascular (CV) disease may reduce left ventricular (LV) echocardiographic abnormalities in diabetic subjects. Plasma N-terminal (NT)-proBNP predicts CV mortality in diabetic patients but the association between P-NT-proBNP and the putative residual abnormalities in such patients are not well described. This study examined echocardiographic measurements of LV hypertrophy, atrial dilatation and LV dysfunction and their relation to P-NT-proBNP levels or subclinical coronary artery disease (CAD) in type 2 diabetic patients with microalbuminuria receiving intensive multifactorial treatment. METHODS: Echocardiography including tissue Doppler imaging and P-NT-proBNP measurements were performed in 200 patients without prior CAD. Patients with P-NT-proBNP > 45.2 ng/L and/or coronary calcium score ≥ 400 were stratified as high risk patients for CAD(n = 133) and examined for significant CAD by myocardial perfusion imaging and/or CT-angiography and/or coronary angiography. RESULTS: LV mass index was 41.2 ± 10.9 g/m(2.7 )and 48 (24%) patients had LV hypertrophy. LA and RA dilatation were found in 54(27%) and 45(23%) patients, respectively, and LV diastolic dysfunction was found in 109(55%) patients. Patients with increased P-NT-proBNP levels did not have more major echocardiographic abnormalities. In 70(53%) of 133 high risk patients significant CAD was demonstrated and patients with LV hypertrophy had increased risk of significant CAD(adjusted odd ratio[CI] was 4.53[1.14-18.06]). CONCLUSION: Among asymptomatic type 2 diabetic patients with microalbuminuria that received intensive multifactorial treatment, P-NT-proBNP levels is not associated with echocardiographic abnormalities. LV diastolic dysfunction was frequently observed, whereas LV hypertrophy was less frequent but associated with significant CAD. BioMed Central 2012-03-05 /pmc/articles/PMC3310741/ /pubmed/22390472 http://dx.doi.org/10.1186/1475-2840-11-19 Text en Copyright ©2012 Reinhard et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Investigation
Reinhard, Henrik
Hansen, Peter R
Wiinberg, Niels
Kjær, Andreas
Petersen, Claus L
Winther, Kaj
Parving, Hans-Henrik
Rossing, Peter
Jacobsen, Peter K
NT-proBNP, echocardiographic abnormalities and subclinical coronary artery disease in high risk type 2 diabetic patients
title NT-proBNP, echocardiographic abnormalities and subclinical coronary artery disease in high risk type 2 diabetic patients
title_full NT-proBNP, echocardiographic abnormalities and subclinical coronary artery disease in high risk type 2 diabetic patients
title_fullStr NT-proBNP, echocardiographic abnormalities and subclinical coronary artery disease in high risk type 2 diabetic patients
title_full_unstemmed NT-proBNP, echocardiographic abnormalities and subclinical coronary artery disease in high risk type 2 diabetic patients
title_short NT-proBNP, echocardiographic abnormalities and subclinical coronary artery disease in high risk type 2 diabetic patients
title_sort nt-probnp, echocardiographic abnormalities and subclinical coronary artery disease in high risk type 2 diabetic patients
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3310741/
https://www.ncbi.nlm.nih.gov/pubmed/22390472
http://dx.doi.org/10.1186/1475-2840-11-19
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