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Plasma concentration of brain natriuretic peptide is related to diastolic function in hypertension
1Institute of Cardiovascular Science and Medicine, University of Hong Kong. mycheung@hkucc.hku.hk
Insights
Plasma brain natriuretic peptide (BNP) levels are elevated in hypertensive patients with diastolic dysfunction. This suggests BNP may help identify diastolic dysfunction in hypertension.
Area of Science:
- Cardiology
- Hypertension Research
- Biomarker Discovery
Background:
- Essential hypertension is linked to elevated plasma brain natriuretic peptide (BNP).
- Left ventricular hypertrophy and diastolic dysfunction are common in hypertension and may influence BNP levels.
Purpose of the Study:
- To investigate the relationship between plasma BNP levels and diastolic dysfunction in patients with essential hypertension.
- To determine if plasma BNP can serve as a biomarker for diastolic dysfunction in hypertensive individuals.
Main Methods:
- Echocardiography was performed on 32 newly diagnosed hypertensive patients.
- Plasma BNP concentrations were measured using radioimmunoassay.
- Doppler transmittal flow (E/A ratio) was assessed to evaluate diastolic function.
Main Results:
- Patients with abnormal Doppler transmittal flow (E/A ratio < 1) exhibited significantly higher median plasma BNP concentrations (12.9 pmol/L) compared to those with normal flow (E/A ratio ≥ 1, 5.9 pmol/L).
- Plasma BNP levels showed a significant negative correlation with the E/A ratio (r = -0.50, P = 0.035).
- Multivariate analysis confirmed that the E/A ratio independently predicts plasma BNP levels, irrespective of age and blood pressure.
Conclusions:
- Plasma BNP levels are influenced by diastolic dysfunction in patients with essential hypertension.
- Further research is warranted to explore the utility of plasma BNP assays in identifying patients with diastolic dysfunction.
Abstract:
1. The plasma brain natriuretic peptide (BNP) concentration is elevated in patients with essential hypertension and normal systolic function. This may be related to left ventricular hypertrophy or diastolic dysfunction, both of which commonly occur in hypertension. 2. Echocardiography was performed on 32 patients with newly diagnosed untreated mild-to-moderate hypertension (19 men, 13 women; mean +/- SD age 51 +/- 15 years; diastolic blood pressure 99 +/- 12 mmHg; systolic blood pressure 153.2 +/- 18.0 mmHg; plasma creatinine 86 +/- 15 mumol/L; creatinine clearance 92.2 +/- 20.5 mL/min; left ventricular mass index 116 +/- 28 g/m2; left ventricular ejection fraction 66 +/- 9%). A 15 mL peripheral venous blood sample was obtained at the time of echocardiography for radioimmunoassay of BNP. 3. Sixteen patients had abnormal Doppler transmittal flow (E/A ratio < 1) and a higher median plasma BNP concentration compared with those patients with E/A > or = 1 (12.9 vs 5.9 pmol/L, respectively; P = 0.006). The plasma BNP level correlated significantly with E/A ratio (r = -0.50; P = 0.035). Multivariate analysis showed that the E/A ratio is related to plasma BNP, independent of age and blood pressure. 4. Our results suggest that the plasma BNP level is influenced by diastolic dysfunction. Further studies are needed to determine whether assay of plasma BNP helps to identify patients with diastolic dysfunction.