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Brain natriuretic hormone predicts stress-induced alterations in diastolic function
Pratik Choksy1, Harry C Davis, James Januzzi
1Georgia Prevention Center/Institute of Public and Preventive Health (HCD, GH, VJBR, GKK), Department of Pediatrics, Medical College of Georgia, Georgia Regents University, Augusta, Georgia; Department of Medicine (Cardiology) (PC, GKK), Medical College of Georgia, Augusta, Georgia; Division of Cardiology (JJ), Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts; and Department of Psychology, The Ohio State University (JT), Columbus, Ohio.
Mental stress impacts heart diastolic function. Brain natriuretic peptide (BNP) levels during stress may indicate diastolic dysfunction in healthy individuals.
Area of Science:
- Cardiology
- Physiology
- Psychosomatic Medicine
Background:
- Mental stress (MS) is known to impair diastolic function (DF), potentially leading to heart failure.
- The role of brain natriuretic peptide (BNP) in mediating the relationship between MS and DF remains unclear.
Purpose of the Study:
- To investigate whether brain natriuretic peptide (BNP) mediates the impact of mental stress on diastolic function (DF) in healthy adults.
- To analyze the relationship between BNP levels and various diastolic function indices under resting and stress conditions.
Main Methods:
- 160 healthy adults (30-50 years) underwent a 2-hour protocol including rest, a videogame stressor, and recovery.
- Hemodynamic data, pro-BNP levels, and diastolic function indices (E/A, E', E/E') were measured throughout the protocol.
- Stepwise regression analyses were used to identify predictors of diastolic function, including age, sex, race, body mass index, pro-BNP, left ventricular mass, blood pressure, and heart rate.
Main Results:
- Diastolic function indices, such as the E/A ratio, were significantly lower during mental stress compared to rest and recovery.
- Resting and stress E/A ratios were predicted by age, pro-BNP, heart rate, and blood pressure.
- Resting and stress E' values were influenced by age, pro-BNP, and left ventricular mass.
- Resting E/E' was associated with race and diastolic blood pressure, while stress E/E' was predicted by pro-BNP, height, and heart rate.
Conclusions:
- Pro-brain natriuretic peptide (pro-BNP) levels are significant predictors of both resting and stress-induced diastolic function.
- Lower BNP levels during mental stress may serve as a potential biomarker for diastolic dysfunction in apparently healthy individuals.
- These findings highlight the interplay between mental stress, BNP, and cardiac diastolic function.