Natriuretic Peptides As A Marker of Left Ventricular Diastolic Dysfunction in Patients With Obesity and Hypertension: Relationship With Doppler Tissue Imaging


ŠPÁC Jiří SOUČEK Miroslav NĚMCOVÁ Helena

Rok publikování 2010
Druh Konferenční abstrakty
Fakulta / Pracoviště MU

Lékařská fakulta

Popis Natriuretic peptide (NP) increased early in patients with left ventricular (LV) systolic dysfunction, but early markers of HF development in patients with obesity and hypertension (HT) and LV diastolic dysfunction (DD) are already not very well known. Methods: 118 (56 years, 62 men) consecutive HT pts (stage I and II) with obesity using the value of 30 of body mass Index (BMI) as a cut-off was divided into two groups: A with BMI<30 (n = 56) and B with BMI>30 (n = 62). LV function was assessed by natriuretic peptide plasma levels (BNP, NT pro BNP). Relative wall thickness, cardiac mass, LV volumes and ejection fraction, velocity of early and late diastolic LV filling maximal velocity (E, A), E/A ratio, deceleration E time from transmitral Doppler, and pulsed doppler tissue imaging of velocities of mitral annular movements (Sm, Em, Am) were calculated by echo. Results: Pts revealed normal systolic function of the LV and the same degrese of LVH (61,19 versus 63,4 g/m2,7). There was no correlation between standard Doppler mitral inflow as well as with parameters of systolic LV function. with NP. P < 0.001 for all) were found between NT pro BNP and Em (r = - 0.82), Sm (r = - 0.7), E/ Em ratio (r = 0.61) and relationship was less significant as the obesity of pts was rising. NP were significantly higher in group A than in group B. The best discriminative for dg. of DD using NT pro BNP in group A was > 280 pg/ml (sensitivity 82%, specificity 76%) and > 170 pg/ml (sensitivity 78%, specificity 74%) in group B. Conclusions: NP can reveal only more severe DD in asymptomatic pts with HT and obesity. Pts with obesity and HT have lower values of NP and diagnostic tresholdes of NT pro BNP for DD should be lower than in HT pts without obesity.
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