Gastouniotis Ioannis, Fragoulis Christos, Antonopoulos Alexis, Kouroutzoglou Alexandrina, Noutsou Marina, Thanopoulou Anastasia, Chrysohoou Christina, Tsioufis Konstantinos P
First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration General Hospital of Athens, 11527 Athens, Greece.
Diabetes Center, 2nd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Hippokration General Hospital of Athens, 11527 Athens, Greece.
Biomedicines. 2024 Nov 27;12(12):2718. doi: 10.3390/biomedicines12122718.
: Natriuretic peptide (NP) levels have been proposed for characterization and risk stratification of heart failure (HF) among patients with cardiovascular disease (CVD). However, their role in patients with diabetes mellitus type 2 (T2DM) has not been well studied and understood. The aim of this study was to assess phenotypical, functional characteristics and imaging parameters in relation to N-terminal pro b-type natriuretic peptide (NT-proBNP) values in T2DM patients without known CVD that may predispose to overt HF. This was a cross-sectional study of 100 consecutive T2DM patients (mean overall age of 67 ± 9 years, 40% women and 60% men) who were enrolled from the outpatient diabetic clinic. Patients underwent a cardiopulmonary exercise test (CPET), and echocardiographic and cardiac magnetic resonance imaging (CMR); serum NT-proBNP was also measured. The mean (standard deviation) NT-proBNP was 149 (±186) pg/mL. Patients in the highest tertile of NT-proBNP values (>107 pg/mL) had lower values of predicted maximum oxygen consumption compared to the lowest quartile (<55 pg/mL) (84% vs. 92%, = 0.018) in the CPET and higher ratio of early diastolic mitral inflow velocity to early diastolic mitral annulus velocity (E/e') (9.0 vs. 7.2, = 0.05) in echocardiography. Finally, there was a negative correlation between right ventricle end diastolic volume in CMR and predicted maximum oxygen consumption (b = -0.225 ± 0.11, = 0.046). NT-proBNP levels seemed to be a useful marker in people with T2DM, as elevated levels reflected ongoing appearance of HF with preserved ejection fraction and were related to CPET and echocardiographic indices of impaired left ventricular diastolic and right ventricular systolic function.
利钠肽（NP）水平已被用于心血管疾病（CVD）患者心力衰竭（HF）的特征描述和风险分层。然而，其在2型糖尿病（T2DM）患者中的作用尚未得到充分研究和理解。本研究的目的是评估无已知CVD但可能易患明显HF的T2DM患者中与N末端B型利钠肽原（NT-proBNP）值相关的表型、功能特征和影像学参数。这是一项对100例连续的T2DM患者（平均总年龄67±9岁，40%为女性，60%为男性）进行的横断面研究，这些患者来自门诊糖尿病诊所。患者接受了心肺运动试验（CPET）、超声心动图和心脏磁共振成像（CMR）检查；同时还检测了血清NT-proBNP。NT-proBNP的平均（标准差）值为149（±186）pg/mL。在CPET中，NT-proBNP值处于最高三分位数（>107 pg/mL）的患者与最低四分位数（<55 pg/mL）的患者相比，预测最大摄氧量较低（84%对92%，P = 0.018）；在超声心动图检查中，二尖瓣舒张早期血流速度与二尖瓣环舒张早期速度之比（E/e'）较高（9.0对7.2，P = 0.05）。最后，CMR中右心室舒张末期容积与预测最大摄氧量之间存在负相关（b = -0.225±0.11，P = 0.046）。NT-proBNP水平似乎是T2DM患者的一个有用标志物，因为升高的水平反映了射血分数保留的HF的持续出现，并且与左心室舒张功能受损和右心室收缩功能受损的CPET及超声心动图指标相关。
