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Mild BNP may indicate LV dysfunction in diabetics
2 September 2010
MedWire News: Dutch researchers report that slightly elevated B-type natriuretic peptide (BNP) levels are associated with increased left ventricular (LV) mass and diastolic dysfunction in patients with Type 2 diabetes.
This association persists irrespective of age and other traditional cardiovascular disease (CVD) risk factors, and is also present, but less pronounced, in patients without diabetes.
Katja van den Hurk and colleagues from the VU University Medical Center in Amsterdam, say their findings imply “that potential risk estimations based on BNP levels should take the presence or absence of Type 2 diabetes into account, since it amplifies the associations.”
The team recruited 197 participants with normal glucose metabolism (NGM), 128 patients with impaired glucose metabolism (IGM), and 204 patients with Type 2 diabetes.
All patients had normal LV wall motion and BNP levels <50 pmol/l (median 4.2 pmol/l).
As reported in the European Journal of Heart Failure, van den Hurk and colleagues found that BNP levels positively correlated with LV mass and LV diastolic dysfunction, with a mean LV mass of 37 and 45 g/m2.7 among males and 39 and 43 g/m2.7 among females with BNP levels <2.8 and >6.7 pmol/l, respectively.
Of note, age and blood pressure also increased with BNP.
After adjustment for CVD risk factors such as age and smoking, the team found a stronger association between elevated BNP levels and LV diastolic dysfunction among patients with diabetes compared with those with IGM or NGM.
The researchers say that their findings imply that “the higher CVD and mortality risk associated with higher BNP levels in a non-heart failure (HF) range [of <200 pmol/l] result from a deteriorated LV diastolic function and LV hypertrophy but not from LV systolic function.”
They conclude that the mildly elevated BNP levels in patients with diabetes may help identify and treat Type 2 diabetes patients at high risk for CVD mortality.
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