Does the relationship between natriuretic hormones and diastolic function differ by race?
Gaston K Kapuku1, Harry C Davis, Patrick Thomas
1Georgia Prevention Institute, Department of Pediatrics, Medical College of Georgia, Georgia Health Sciences University, Augusta, USA. gkapuku@georgiahealth.edu
Insights
Racial differences exist in how natriuretic peptides (NP) affect cardiac function. This study found NP protective actions are more pronounced in whites, suggesting a need for race-specific heart failure prevention strategies.
Area of Science:
- Cardiology
- Cardiovascular Physiology
- Racial Health Disparities
Background:
- Heart failure incidence and onset differ between Black and White populations, linked to higher rates of hypertension and diabetes in Black individuals.
- Natriuretic peptides (NP) play a crucial role in maintaining cardiac function by regulating pressure and promoting natriuresis.
- The influence of race on the relationship between NP action and cardiac function remains largely unexplored.
Purpose of the Study:
- To investigate potential racial differences in the association between natriuretic peptide levels and cardiac function indices.
- To determine if the protective mechanisms of NP vary between White and Black individuals under stress.
Main Methods:
- A cohort of 55 normotensive adults (21 White, 27 Black) underwent a 2-hour protocol including rest, a video game stressor, and recovery.
- Cardiac function was assessed using echocardiography (mitral inflow, tissue Doppler) at regular intervals.
- Blood samples were collected to measure pro-atrial natriuretic peptide (pro-ANP) and pro-brain natriuretic peptide (pro-BNP) levels.
Main Results:
- Significant racial differences were observed in the correlations between NP levels and diastolic function parameters (E/A ratio, E(m), E(m)/A(m), E/E(m)) during rest and stress.
- Specifically, stronger correlations between NP levels and diastolic function indices were noted in White participants compared to Black participants.
- These associations highlight distinct relationships between NP action and cardiac mechanics across racial groups.
Conclusions:
- The findings suggest that the protective effects of natriuretic peptides on cardiac function are more pronounced in White individuals than in Black individuals.
- These race-dependent differences in NP action may contribute to the disparities in heart failure development and progression.
- Further research is warranted to elucidate the underlying mechanisms and inform race-specific therapeutic strategies.
Introduction:
Heart failure develops earlier and is more prevalent in blacks than whites because of their higher incidence of hypertension and diabetes and likely subsequent diastolic dysfunction. Natriuretic peptides (NP) prevent cardiac malfunction through pressure, natriuresis action. However, whether race affects the relationships of NP action with cardiac function is unknown.
Methods:
To assess this, 55 (21 whites and 27 males) normotensive adults underwent a 2-hour protocol of 40 minutes rest, video game stressor and recovery. Mitral inflow and myocardial velocities (tissue Doppler) were recorded every 20 minutes. Blood pressure and heart rate were obtained at 10-minute intervals. Blood samples for pro-atrial NP and pro-brain NP (pro-BNP) were collected every 40 minutes.
Results:
There were differences in the association between (1) the changes from rest to stress for E/A ratio and double product (whites, r = -0.42; blacks, r = 0. 10; P = 0.034 for difference between correlations); (2) stress E(m) and pro-atrial NP (whites, r = 0.59; blacks, r = -0.25; P = 0.025); (3) rest E(m) and BNP (whites, r = 0.83; blacks r = -0.17; P = 000); (4) rest E(m)/A(m) and pro-BNP (whites, r = 0.70; blacks, r = -0.42; P = 0.003); (5) rest E/E(m) and pro-BNP (whites, r = -0.61; blacks, r = 0.31; P = 0.015) and (6) stress E and pro-BNP (whites, r = 0.56; blacks, r = -0.18; P = 0.043).
Conclusion:
The higher correlations between levels of NP and diastolic function indices both at rest and stress suggest that NP protective action is more pronounced in whites than in blacks.
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