The effects of central arterial pressure and autonomic dysfunction on elevations in N-terminal pro-B-type natriuretic peptide (NT-proBNP) in men with diabetes

S. Bunce; A. Stride; C. Matthews; S. Shaw; J.C. Smith

doi:10.1016/j.artres.2008.03.002

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Volume 2, Issue 2, May 2008, Pages 60 - 66

The effects of central arterial pressure and autonomic dysfunction on elevations in N-terminal pro-B-type natriuretic peptide (NT-proBNP) in men with diabetes

Authors

S. Bunce^a, A. Stride^a, C. Matthews^a, S. Shaw^b, J.C. Smith^a^{, *}

^aDepartment of Medicine, Torbay Hospital, Devon, TQ2 7AA, UK

^bSchool of Mathematics and Statistics, University of Plymouth, PL4 8AA, UK

^*Corresponding author. Department of Diabetes & Endocrinology, Torbay Hospital, Lawes Bridge, Torquay, TQ2 7AA, UK. Tel.:+44 01803 654923; fax: +44 01803 655741. E-mail address: jamie.smith2@nhs.net (J.C. Smith).

Corresponding Author

J.C. Smith

Received 9 November 2007, Revised 12 March 2008, Accepted 17 March 2008, Available Online 23 April 2008.

DOI: 10.1016/j.artres.2008.03.002 How to use a DOI?
Keywords: Arterial stiffness; Augmentation index; Autonomic neuropathy; NT-proBNP
Abstract: Background: In diabetes, left ventricular dysfunction independent of coronary disease is common and is associated with elevations in NT-proBNP. Our aims were to determine the relative importance of central aortic pressure, cardiovascular autonomic function and arterial stiffness as predictors of elevated NT-proBNP.

Methods: Fifty males with diabetes mellitus and 21 males with IGT were studied. Arterial stiffness and wave reflections were assessed by measuring aortic and brachial pulse wave velocity (PWV) and augmentation index (AIX). Cardiovascular autonomic function was assessed by measurements of heart rate variability following standard manoeuvres.

Results: Comparing diabetes versus IGT subjects (mean ± SD), both aortic PWV (9.7 ± 2.4 versus 8.2 ± 1.4 m/s, p < 0.01) and cardiovascular autonomic dysfunction (autonomic score 2.3 ± 1.3 versus 1.6 ± 1.0, p < 0.01) were greater in diabetes subjects. NT-proBNP levels correlated with central and brachial systolic pressure (r = 0.74, p < 0.0001 and r = 0.66, p < 0.0001, respectively), aortic PWV (r = 0.43, p < 0.01), AIX (r = 0.55, p < 0.0001), and autonomic function (r = 0.37, p < 0.01). Multiple regression analysis amongst diabetic subjects showed central systolic blood pressure to be the strongest predictor of NT-proBNP concentrations.

Conclusions: Elevated central arterial pressure is a strong predictor of NT-proBNP concentrations in diabetic men without clinically apparent left ventricular dysfunction. This is indicative of the key influence of unfavourable large artery haemodynamics on the development of left ventricular dysfunction in diabetes.
Copyright: © 2008 Association for Research into Arterial Structure and Physiology. Published by Elsevier B.V. All rights reserved.
Open Access: This is an open access article distributed under the CC BY-NC license.

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Journal: Artery Research
Volume-Issue: 2 - 2
Pages: 60 - 66
Publication Date: 2008/04/23
ISSN (Online): 1876-4401
ISSN (Print): 1872-9312
DOI: 10.1016/j.artres.2008.03.002 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC license.

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ris enw bib

TY  - JOUR
AU  - S. Bunce
AU  - A. Stride
AU  - C. Matthews
AU  - S. Shaw
AU  - J.C. Smith
PY  - 2008
DA  - 2008/04/23
TI  - The effects of central arterial pressure and autonomic dysfunction on elevations in N-terminal pro-B-type natriuretic peptide (NT-proBNP) in men with diabetes
JO  - Artery Research
SP  - 60
EP  - 66
VL  - 2
IS  - 2
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2008.03.002
DO  - 10.1016/j.artres.2008.03.002
ID  - Bunce2008
ER  -

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