Cargando…

Plasma NT-proBNP levels associated with cardiac structural abnormalities in asymptomatic health examinees with preserved ejection fraction: a retrospective cross-sectional study

OBJECTIVES: Stage B heart failure (HF) is defined as an asymptomatic abnormality of the heart structure or function. The circulating level of N-terminal pro-B-type natriuretic peptide (NT-proBNP) is elevated in symptomatic patients with left ventricular (LV) dysfunction caused by a structural or fun...

Descripción completa

Detalles Bibliográficos
Autores principales: Nah, Eun-Hee, Kim, Seong Yoon, Cho, Seon, Kim, Suyoung, Cho, Han-Ik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6500281/
https://www.ncbi.nlm.nih.gov/pubmed/31005928
http://dx.doi.org/10.1136/bmjopen-2018-026030
_version_ 1783415920334471168
author Nah, Eun-Hee
Kim, Seong Yoon
Cho, Seon
Kim, Suyoung
Cho, Han-Ik
author_facet Nah, Eun-Hee
Kim, Seong Yoon
Cho, Seon
Kim, Suyoung
Cho, Han-Ik
author_sort Nah, Eun-Hee
collection PubMed
description OBJECTIVES: Stage B heart failure (HF) is defined as an asymptomatic abnormality of the heart structure or function. The circulating level of N-terminal pro-B-type natriuretic peptide (NT-proBNP) is elevated in symptomatic patients with left ventricular (LV) dysfunction caused by a structural or functional abnormality. This study investigated the association of the NT-proBNP level with echocardiography-detected cardiac structural or diastolic abnormalities in asymptomatic subjects with preserved LV systolic function (ejection fraction >50%). METHODS: We retrospectively studied 652 health examinees who underwent echocardiography and an NT-proBNP test at a health-promotion centre in Seoul, between January 2016 and September 2018. The left ventricular mass index (LVMI) and the left atrial dimension (LAD) were used as markers for structural abnormalities, and the mean e’ velocity and mitral early flow velocity/early diastolic tissue velocity (E/e’) ratio were used as markers for diastolic dysfunction. The plasma NT-proBNP level was measured using electrochemiluminescence immunoassay (DPC Immulite 2000 XPi, Siemens Healthcare Diagnostics, Tarrytown, New York, USA). RESULTS: Subjects with preclinical structural abnormalities were older and had a higher body mass index (BMI), higher blood pressure, lower high-density lipoprotein cholesterol level, higher NT-proBNP level, and higher E/e’ (p<0.05). Multivariate regression analysis indicated that the factors associated with a higher NT-proBNP level were older age, female sex, lower BMI, higher creatinine level, higher LVMI and higher LAD (p<0.01). CONCLUSION: Diastolic dysfunction is not associated with higher NT-proBNP levels, whereas preclinical cardiac structural abnormalities, as well as older age, female sex, lower BMI, and higher creatinine level, are associated with higher NT-proBNP levels.
format Online
Article
Text
id pubmed-6500281
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-65002812019-05-21 Plasma NT-proBNP levels associated with cardiac structural abnormalities in asymptomatic health examinees with preserved ejection fraction: a retrospective cross-sectional study Nah, Eun-Hee Kim, Seong Yoon Cho, Seon Kim, Suyoung Cho, Han-Ik BMJ Open Cardiovascular Medicine OBJECTIVES: Stage B heart failure (HF) is defined as an asymptomatic abnormality of the heart structure or function. The circulating level of N-terminal pro-B-type natriuretic peptide (NT-proBNP) is elevated in symptomatic patients with left ventricular (LV) dysfunction caused by a structural or functional abnormality. This study investigated the association of the NT-proBNP level with echocardiography-detected cardiac structural or diastolic abnormalities in asymptomatic subjects with preserved LV systolic function (ejection fraction >50%). METHODS: We retrospectively studied 652 health examinees who underwent echocardiography and an NT-proBNP test at a health-promotion centre in Seoul, between January 2016 and September 2018. The left ventricular mass index (LVMI) and the left atrial dimension (LAD) were used as markers for structural abnormalities, and the mean e’ velocity and mitral early flow velocity/early diastolic tissue velocity (E/e’) ratio were used as markers for diastolic dysfunction. The plasma NT-proBNP level was measured using electrochemiluminescence immunoassay (DPC Immulite 2000 XPi, Siemens Healthcare Diagnostics, Tarrytown, New York, USA). RESULTS: Subjects with preclinical structural abnormalities were older and had a higher body mass index (BMI), higher blood pressure, lower high-density lipoprotein cholesterol level, higher NT-proBNP level, and higher E/e’ (p<0.05). Multivariate regression analysis indicated that the factors associated with a higher NT-proBNP level were older age, female sex, lower BMI, higher creatinine level, higher LVMI and higher LAD (p<0.01). CONCLUSION: Diastolic dysfunction is not associated with higher NT-proBNP levels, whereas preclinical cardiac structural abnormalities, as well as older age, female sex, lower BMI, and higher creatinine level, are associated with higher NT-proBNP levels. BMJ Publishing Group 2019-04-20 /pmc/articles/PMC6500281/ /pubmed/31005928 http://dx.doi.org/10.1136/bmjopen-2018-026030 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Cardiovascular Medicine
Nah, Eun-Hee
Kim, Seong Yoon
Cho, Seon
Kim, Suyoung
Cho, Han-Ik
Plasma NT-proBNP levels associated with cardiac structural abnormalities in asymptomatic health examinees with preserved ejection fraction: a retrospective cross-sectional study
title Plasma NT-proBNP levels associated with cardiac structural abnormalities in asymptomatic health examinees with preserved ejection fraction: a retrospective cross-sectional study
title_full Plasma NT-proBNP levels associated with cardiac structural abnormalities in asymptomatic health examinees with preserved ejection fraction: a retrospective cross-sectional study
title_fullStr Plasma NT-proBNP levels associated with cardiac structural abnormalities in asymptomatic health examinees with preserved ejection fraction: a retrospective cross-sectional study
title_full_unstemmed Plasma NT-proBNP levels associated with cardiac structural abnormalities in asymptomatic health examinees with preserved ejection fraction: a retrospective cross-sectional study
title_short Plasma NT-proBNP levels associated with cardiac structural abnormalities in asymptomatic health examinees with preserved ejection fraction: a retrospective cross-sectional study
title_sort plasma nt-probnp levels associated with cardiac structural abnormalities in asymptomatic health examinees with preserved ejection fraction: a retrospective cross-sectional study
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6500281/
https://www.ncbi.nlm.nih.gov/pubmed/31005928
http://dx.doi.org/10.1136/bmjopen-2018-026030
work_keys_str_mv AT naheunhee plasmantprobnplevelsassociatedwithcardiacstructuralabnormalitiesinasymptomatichealthexamineeswithpreservedejectionfractionaretrospectivecrosssectionalstudy
AT kimseongyoon plasmantprobnplevelsassociatedwithcardiacstructuralabnormalitiesinasymptomatichealthexamineeswithpreservedejectionfractionaretrospectivecrosssectionalstudy
AT choseon plasmantprobnplevelsassociatedwithcardiacstructuralabnormalitiesinasymptomatichealthexamineeswithpreservedejectionfractionaretrospectivecrosssectionalstudy
AT kimsuyoung plasmantprobnplevelsassociatedwithcardiacstructuralabnormalitiesinasymptomatichealthexamineeswithpreservedejectionfractionaretrospectivecrosssectionalstudy
AT chohanik plasmantprobnplevelsassociatedwithcardiacstructuralabnormalitiesinasymptomatichealthexamineeswithpreservedejectionfractionaretrospectivecrosssectionalstudy