NT-proBNP predicts impaired myocardial function in newly diagnosed hypertensive patients with preserved ejection fraction

Clin Exp Hypertens. 2014;36(5):289-94. doi: 10.3109/10641963.2013.810234. Epub 2013 Jul 18.

Abstract

N-terminal pro-brain natriuretic peptide (NT-proBNP) is an excellent biomarker to diagnose left ventricular (LV) dysfunction. LV myocardial performance index (MPI-Tei index) is commonly used as a measure of combined systolic and diastolic function. We aimed to investigate the relationship between NT-proBNP and tissue Doppler derived MPI in newly diagnosed hypertensive patients with preserved LV ejection fraction (LVEF). We studied 236 patients with newly diagnosed HT (mean age; 52.9 ± 5.2 years). Echocardiographic examination was performed in all patients. LV mass index (LVMI) was calculated. Conventional Doppler indices (E and A waves) were recorded. The MPI value was obtained from the tissue Doppler derived ejection time, isovolumic contraction and relaxation times. The patients were divided into two groups according to the median NT-proBNP value (NT-proBNPlow group <114 pg/ml and NT-proBNPhigh group ≥114 pg/ml). Patients with NT-proBNPhigh were older and had higher levels of glucose and creatinine, lower E/A ratio and higher LVMI and MPI values than patients with NT-proBNPlow. However, LVEF were similar among the groups. Multiple linear regression analysis showed that NT-proBNP was independently associated with age, LVMI, MPI and E/A ratio. Increased NT-proBNP level was independently associated with impaired myocardial performance index in newly diagnosed hypertensive patients with preserved LVEF.

Keywords: NT-proBNP; Tei index; hypertension; myocardial performance.

MeSH terms

  • Adult
  • Aged
  • Biomarkers
  • Echocardiography, Doppler*
  • Female
  • Heart / physiopathology*
  • Humans
  • Hypertension / diagnosis
  • Hypertension / diagnostic imaging
  • Hypertension / physiopathology*
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood*
  • Peptide Fragments / blood*
  • Ventricular Dysfunction, Left / physiopathology*
  • Ventricular Function, Left / physiology*

Substances

  • Biomarkers
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain