Relative B-Type Natriuretic Peptide Deficiency May Exist in Diastolic Dysfunction in Subclinical Population
- PMID: 38736848
- PMCID: PMC11081706
- DOI: 10.1253/circrep.CR-24-0026
Relative B-Type Natriuretic Peptide Deficiency May Exist in Diastolic Dysfunction in Subclinical Population
Abstract
Background: Heart failure patients are deficient in B-type natriuretic peptide (BNP) but the significance of subclinical BNP deficiency is unclear. Methods and Results: A total of 1,398 subjects without cardiovascular disease, with left ventricular ejection fraction (LVEF) ≥50% and BNP level <100 pg/mL, were selected from a 2005-2008 health checkup in Arita-cho, Japan, and divided into 2 groups: with and without LV diastolic dysfunction (DD+ or DD-). We performed propensity score matching on non-cardiac factors affecting BNP levels and analyzed 470 subjects in each group (372/940 men; median age, 66 years). The DD(+) group showed higher lateral E/e', an index of estimated left ventricular filling pressure, and greater prevalence of concentric hypertrophy (CH) despite similar BNP levels, suggesting a relative deficiency of BNP in DD(+) compared with DD(-). Multivariable logistic regression analysis revealed an increase in BNP correlated with decreased odds of CH (adjusted odds ratio [aOR] 0.663, 95% confidence interval (CI) 0.484-0.909, P=0.011), whereas an increase in lateral E/e' was associated with increased odds of CH (aOR, 2.881; 95% CI, 1.390-5.973; P=0.004). Furthermore, CH in combination with diastolic dysfunction independently predicted major adverse cardiovascular events (hazard ratio 3.272, 95% CI 1.215-8.809; P=0.019). Conclusions: Relative BNP deficiency was associated with CH, which had a poor prognosis in patients with diastolic dysfunction.
Keywords: B-type natriuretic peptide; Diastolic dysfunction; Left ventricular hypertrophy.
Copyright © 2024, THE JAPANESE CIRCULATION SOCIETY.
Conflict of interest statement
O.T., S.I. are members of Circulation Reports’ Editorial Team. The other authors declare that there are no conflicts of interest.
Figures
![Figure 1.](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/11081706/bin/circrep-6-151-g001.gif)
![Figure 2.](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/11081706/bin/circrep-6-151-g002.gif)
![Figure 3.](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/11081706/bin/circrep-6-151-g003.gif)
Similar articles
-
Lower B-type natriuretic peptide levels predict left ventricular concentric remodelling and insulin resistance.ESC Heart Fail. 2022 Feb;9(1):636-647. doi: 10.1002/ehf2.13700. Epub 2021 Nov 16. ESC Heart Fail. 2022. PMID: 34786876 Free PMC article.
-
Diastolic Cardiac Function Improvement by Liraglutide Is Mainly Body Weight Reduction Dependent but Independently Contributes to B-Type Natriuretic Peptide Reduction in Patients with Type 2 Diabetes with Preserved Ejection Fraction.J Diabetes Res. 2021 Mar 27;2021:8838026. doi: 10.1155/2021/8838026. eCollection 2021. J Diabetes Res. 2021. PMID: 33855087 Free PMC article.
-
Left Ventricular Diastolic Dysfunction is Associated with Renal Dysfunction, Poor Survival and Low Health Related Quality of Life in Cirrhosis.J Clin Exp Hepatol. 2019 May-Jun;9(3):324-333. doi: 10.1016/j.jceh.2018.08.008. Epub 2018 Aug 30. J Clin Exp Hepatol. 2019. PMID: 31360025 Free PMC article.
-
Combination of ST2 and B-type natriuretic peptide in diabetic patients with acute heart failure: relation with ventricular stiffness and outcome.J Cardiovasc Med (Hagerstown). 2019 Feb;20(2):81-90. doi: 10.2459/JCM.0000000000000741. J Cardiovasc Med (Hagerstown). 2019. PMID: 30540645
-
Predictive value of B-type natriuretic peptides in detecting latent left ventricular diastolic dysfunction in beta-thalassemia major.Am Heart J. 2010 Jan;159(1):68-74. doi: 10.1016/j.ahj.2009.10.025. Am Heart J. 2010. PMID: 20102869
References
-
- Goetze JP, Bruneau BG, Ramos HR, Ogawa T, de Bold MK, de Bold AJ.. Cardiac natriuretic peptides. Nat Rev Cardiol 2020; 17: 698–717, doi:10.1038/s41569-020-0381-0. - PubMed
-
- Miyashita Y, Tsukamoto O, Matsuoka K, Kamikubo K, Kuramoto Y, Ying FH, et al.. The CR9 element is a novel mechanical load-responsive enhancer that regulates natriuretic peptide genes expression. FASEB J 2021; 35: e21495, doi:10.1096/fj.202002111RR. - PubMed
-
- Nishikimi T, Yoshihara F, Morimoto A, Ishikawa K, Ishimitsu T, Saito Y, et al.. Relationship between left ventricular geometry and natriuretic peptide levels in essential hypertension. Hypertension 1996; 28: 22–30, doi:10.1161/01.hyp.28.1.22. - PubMed
-
- Goda A, Nakao S, Tsujino T, Yuba M, Otsuka M, Matsumoto M, et al.. Determinants of plasma brain natriuretic peptide levels in untreated hypertensive patients. J Echocardiogr 2011; 9: 103–108, doi:10.1007/s12574-011-0086-9. - PubMed