Relationship between natriuretic peptides and echocardiography parameters in patients with poorly regulated type 2 diabetes

Abstract

This study evaluated the relationship between natriuretic peptide levels and a wide range of echocardiography parameters in a population of thirty-three patients with poorly regulated type 2 diabetes, and no known heart failure. Natriuretic peptides brain natriuretic peptide (BNP) and N-terminal prohormone BNP (NT-proBNP) were measured. Transthoracic echocardiography was performed and cardiac volumes and ejection fraction were measured. Doppler and tissue Doppler were measured and diastolic function was stratified according to recent guidelines. Very few echocardiography parameters were correlated with BNP or NT-proBNP levels. However, left atrial end-systolic volume indexed for body surface area was correlated with natural logarithm (ln) BNP and ln NT-proBNP (r = 0.62 and r = 0.60; P < 0.05). There were significant differences in ln BNP and ln NT-proBNP levels between those with normal and those with abnormal diastolic function (1.4 vs 3.1; P < 0.001 and 3.4 vs 5.8; P < 0.001). This study showed that very few echocardiography parameters were correlated with BNP or NT-proBNP levels in patients with poorly regulated type 2 diabetes, which in part contradicts previous studies in other diabetic populations. The exception was left atrial end-systolic volume that showed a moderate correlation with BNP or NT-proBNP levels. There were significant differences in BNP and NT-proBNP levels between the group with normal left ventricular diastolic function and the group with abnormal diastolic function.

Keywords:

• type 2 diabetes
• natriuretic peptides
• echocardiography

Acknowledgements

Cardiac sonographer Ingrid Andersson is acknowledged for acquiring echocardiography images. The study was in part financially supported by grants from Sanofi-Aventis, The Crafoord Foundation, and The Swedish Heart and Lung Association. The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology.

Disclosure

Magnus Dencker has no conflict of interest to declare. Martin Stagmo has received speaker’s fees from Sanofi-Aventis and through his spouse owns shares and stock options in NovoNordisk A/S. Mozhgan Dorkhan has served as speaker for Eli Lilly and Novartis, and received a scholarship from Sanofi-Aventis.