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

Figures & data

Figure 1 The figure displays the unadjusted relationship between left atrial end-systolic volume indexed for body surface area (BSA) indexed left atrial end-systolic volume (LAVI) and ln brain natriuretic peptide (ln BNP).

Figure 2 The figure displays the unadjusted relationship between left atrial end-systolic volume indexed for body surface area (BSA) indexed left atrial end-systolic volume (LAVI) and ln N-terminal pro brain natriuretic peptide (ln NT-proBNP).

Table 1 Subjects’ anthropometric, echocardiography and laboratory characteristics. Values are mean ± SD

Men/women	23/10
Age (yrs)	61.4 ± 7.4
Height (cm)	170.9 ± 9.0
Body mass (kg)	90.4 ± 16.5
BMI (kg/m^2)	31.0 ± 5.6
BSA (m^2)	2.0 ± 0.2
Diabetes duration (years)	9.8 ± 6.2
HbA1c (%)	8.2 ± 1.4
Systolic blood pressure (mm Hg)	144 ± 17
Diastolic blood pressure (mm Hg)	83 ± 8
BNP (pmol/l)	7.8 ± 9.3
eGFR (ml/min)	117 ± 39
NT-proBNP (ng/l)	86 ± 123
LVMI (g/m^2)	82 ± 17
LVDVI (ml/m^2)	50 ± 8
LVSVI (ml/m^2)	19 ± 4
LAVI (ml/m^2)	27 ± 6
IVSI (mm/m^2)	5.1 ± 0.5
POSTI (mm/m^2)	4.5 ± 0.4
EF (%)	63 ± 5
E (cm/s)	76 ± 20
A (cm/s)	84 ± 19
E/A	0.9 ± 0.3
DT (msec)	218 ± 44
S (cm/s)	64 ± 10
D (cm/s)	49 ± 14
S/D	1.4 ± 0.3
Sm septal (cm/s)	7.6 ± 1.6
Em septal (cm/s)	6.7 ± 1.4
Am septal (cm/s)	9.6 ± 1.8
Sm lateral (cm/s)	8.9 ± 1.6
Em lateral (cm/s)	8.7 ± 2.6
Am lateral (cm/s)	11.4 ± 2.5
E/Em	10.3 ± 3.7
Em/Am septal	0.7 ± 0.2
Em/Am lateral	0.8 ± 0.3
Em/Am average	0.7 ± 0.2
Sm right ventricle (cm/s)	13.6 ± 3.0
Em right ventricle (cm/s)	9.8 ± 2.9
Am right ventricle (cm/s)	14.5 ± 3.1

Abbreviations: BNP, brain natriuretic peptide; NT-proBNP, N-terminal pro brain natriuretic peptide. Indexed for BSA: POSTI, posterior wall thickness; IVSI, interventricularseptum thickness; LVMI, left ventricular mass; LVDVI, left ventricular end-diastolic volume; LVSVI, left ventricular end-systolic volume; LAVI, left atrial end-systolic volume; EF, ejection fraction; E, peak of early diastolic; A, late diastolic; mitral flow velocities. DT, deceleration time of E-wave; S, Pulmonary vein peak velocities systole; D, diastole. pulsed tissue Doppler imaging velocities; Sm, peak systolic; Em, early diastolic velocities; Am, late diastolic velocities.

Table 2 Pearson correlation coefficients, with adjustment for sex, between in BNP and in NT-proBNP versus anthropometric and echocardiography parameters

Echocardiography parameter	ln BNP	ln NT-proBNP
Age (yrs)	0.04	0.27
Height (cm)	0.09	0.02
Body mass (kg)	0.36*	0.17
BMI (kg/m^2)	0.32	0.14
BSA (m^2)	0.33	0.16
eGFR (ml/min)	0.18	–0.09
LVMI (g/m^2)	0.11	0.33
LVDVI (ml/m^2)	0.32	0.16
LVSVI (ml/m^2)	0.22	0.16
LAVI (ml/m^2)	0.62**	0.60**
IVSI (mm/m^2)	–0.31	0.20
POSTI (mm/m^2)	–0.25	0.06
EF (%)	–0.05	–0.10
E	0.25	0.25
A	–0.12	0.16
E/A	0.30	0.08
DT	–0.17	–0.24
S	0.02	0.19
D	0.25	0.29
S/D	–0.29	–0.18
Sm septal	–0.21	–0.11
Em septal	0.15	0.18
Am septal	–0.24	–0.21
Sm lateral	–0.29	–0.11
Em lateral	–0.05	–0.07
Am lateral	–0.05	0.07
E/Em	0.10	0.14
Em/Am septal	0.31	0.32
Em/Am lateral	–0.05	–0.11
Em/Am average	0.09	0.03
S right ventricle	0.08	0.13
Em right ventricle	0.25	0.15
Am right ventricle	–0.08	–0.00

Notes:

* Indicate statistical significant correlation, P < 0.05 and

** P < 0.001. Indexed for BSA.

Abbreviations: POSTI, posterior wall thickness; IVSI, interventricularseptum thickness; LVMI, left ventricular mass; LVDVI, left ventricular end-diastolic volume; LVSVI, left ventricular end-systolic volume; LAVI, left atrial end-systolic volume; EF, ejection fraction; E, peak of early diastolic; A, late diastolic; mitral flow velocities. DT, deceleration time of E-wave; S, pulmonary vein peak velocities systole; D, diastole. pulsed tissue Doppler imaging velocities: Sm, peak systolic; Em, early diastolic velocities; Am, late diastolic velocities.

Figure 3 The figure displays the study population according to classification of left ventricular diastolic function and levels of ln brain natriuretic peptide (ln BNP).

Figure 4 The figure displays the study population according to classification of left ventricular diastolic function and levels of ln N-terminal pro brain natriuretic peptide (ln NT-proBNP).

Table 3 Subjects’ anthropometric, laboratory, and selected echocardiography characteristics. Values are mean ± SD

Variable	Normal	Abnormal	P-value
Men/women	20/9	3/1	>0.2
Age (yrs)	60.9 ± 7.3	65.3 ± 7.3	>0.2
Height (cm)	170.4 ± 9.1	174.3 ± 9.1	>0.2
Body mass (kg)	89.3 ± 16.8	98.5 ± 16.8	>0.2
BMI (kg/m^2)	30.8 ± 5.6	32.7 ± 5.6	>0.2
BSA (m^2)	2.0 ± 0.2	2.1 ± 0.2	>0.2
Diabetes duration (years)	9.1 ± 5.3	15.0 ± 5.3	0.08
HbA1c (%)	8.1 ± 1.3	9.0 ± 1.3	>0.2
Systolic blood pressure (mm Hg)	141.1 ± 15.3	161.0 ± 15.4	0.02
Diastolic blood pressure (mm Hg)	82.0 ± 7.8	86.5 ± 7.8	>0.2
eGFR (ml/min)	118 ± 40	116 ± 38	>0.20
BNP (pmol/l)	5.3 ± 3.4	26.0 ± 3.4	<0.001
ln BNP	1.4 ± 0.8	3.1 ± 0.8	<0.001
NT-proBNP (ng/l)	48.3 ± 47.4	360.0 ± 47.4	<0.001
ln NT-proBNP	3.4 ± 1.1	5.8 ± 1.1	<0.001
LVMI (g/m^2)	80.7 ± 16.6	93.2 ± 16.6	0.17
LVDVI (ml/m^2)	49.4 ± 7.8	56.8 ± 7.8	0.07
LVSVI (ml/m^2)	18.3 ± 4.3	21.1 ± 4.3	>0.20
LAVI (ml/m^2)	25.2 ± 4.1	38.9 ± 4.1	<0.001
IVSI (mm/m^2)	5.1 ± 0.4	5.2 ± 0.4	>0.2
POSTI (mm/m^2)	4.5 ± 0.4	4.5 ± 0.4	>0.2
EF (%)	63.1 ± 5.2	63.0 ± 5.2	> 0.2
E/A	0.9 ± 0.3	1.1 ± 0.3	>0.2
DT (msec)	219 ± 44	211 ± 44	>0.2
S/D	1.4 ± 0.3	1.2 ± 0.3	>0.2
E/Em	10.0 ± 3.6	12.5 ± 3.6	0.20
Sm septal (cm/s)	7.6 ± 1.7	7.2 ± 1.7	>0.2
Em septal (cm/s)	6.7 ± 1.4	7.0 ± 1.4	>0.2
Am septal (cm/s)	9.7 ± 1.8	8.2 ± 1.8	0.09
Sm lateral (cm/s)	9.1 ± 1.5	7.5 ± 1.5	0.07
Em lateral (cm/s)	8.8 ± 2.7	8.3 ± 2.7	>0.2
Am lateral (cm/s)	11.6 ± 2.4	9.8 ± 2.4	0.19

Notes: The study population is divided into those with normal versus abnormal diastolic function.

Abbreviations: BNP, brain natriuretic peptide; NT-proBNP, N-terminal pro brain natriuretic peptide. Indexed for BSA: POSTI, posterior wall thickness; IVSI, interventricularseptum thickness; LVMI, left ventricular mass; LVDVI, left ventricular end-diastolic volume; LVSVI, left ventricular end-systolic volume; LAVI, left atrial end-systolic volume; EF, ejection fraction; E, peak of early diastolic; A, late diastolic; mitral flow velocities. DT, deceleration time of E-wave; S, pulmonary vein peak velocities systole; D, diastole. pulsed tissue Doppler imaging velocities; Sm, peak systolic; Em, early diastolic velocities; Am, late diastolic velocities.

Table 4 Subjects’ anthropometric, laboratory, and selected echocardiography characteristics

Variable	Normal	Elevated	P-value
Men/women	19/6	4/4	0.17
Age (yrs)	61.5 ± 7.1	61.0 ± 8.9	>0.20
Height (cm)	172 ± 7	167 ± 10	0.13
Body mass (kg)	90 ± 17	93 ± 15	>0.20
BMI (kg/m^2)	30.1 ± 5.0	33.7 ± 6.8	0.12
BSA (m^2)	2.0 ± 0.2	2.0 ± 0.2	>0.20
Diabetes duration (years)	9.0 ± 5.9	12.5 ± 7.1	0.17
HbA1c (%)	7.9 ± 1.0	9.2 ± 2.0	0.02
Systolic blood pressure (mm Hg)	142 ± 17	147 ± 17	>0.20
Diastolic blood pressure (mm Hg)	82 ± 8	83 ± 5	>0.20
eGFR (ml/min)	114 ± 36	129 ± 51	0.20
BNP (pmol/l)	6.5 ± 5.9	11.9 ± 15.9	0.16
ln BNP	1.5 ± 0.9	1.9 ± 1.2	>0.20
NT-proBNP (ng/l)	74 ± 115	123 ± 149	>0.20
ln NT-proBNP	3.5 ± 1.3	4.0 ± 1.5	>0.20
LVMI (g/m^2)	83.7 ± 16.5	77.6 ± 17.8	>0.20
LVDVI (ml/m^2)	50.4 ± 8.1	50.1 ± 7.0	>0.20
LVSVI (ml/m^2)	18.9 ± 4.5	18.0 ± 3.6	>0.20
LAVI (ml/m^2)	26.1 ± 6.0	29.4 ± 6.7	>0.20
IVSI (mm/m^2)	5.2 ± 0.4	4.9 ± 0.6	0.07
POSTI (mm/m^2)	4.5 ± 0.4	4.3 ± 0.4	0.08
EF (%)	63 ± 5	64 ± 5	>0.20
E/A	0.9 ± 0.3	1.0 ± 0.3	>0.20
DT (msec)	222 ± 44	207 ± 44	>0.20
S/D	1.4 ± 0.2	1.4 ± 0.4	>0.20
E/Em	8.6 ± 1.7	15.6 ± 3.1	<0.001
Sm septal (cm/s)	7.9 ± 1.7	6.7 ± 1.0	0.08
Em septal (cm/s)	7.0 ± 1.4	5.8 ± 1.2	0.03
Am septal (cm/s)	9.9 ± 1.7	8.4 ± 1.6	0.04
Sm lateral (cm/s)	9.2 ± 1.4	8.0 ± 1.8	0.07
Em lateral (cm/s)	9.3 ± 2.7	7.0 ± 1.8	0.04
Am lateral (cm/s)	11.2 ± 2.0	11.9 ± 3.7	>0.20

Notes: Values are mean ± SD. The study population is divided into those with normal versus elevated filling pressure estimated by echocardiography.

Abbreviations: BNP, brain natriuretic peptide; NT-proBNP, N-terminal pro brain natriuretic peptide. Indexed for BSA: POSTI, Pposterior wall thickness; IVSI, interventricularseptum thickness; LVMI, left ventricular mass; LVDVI, left ventricular end-diastolic volume; LVSVI, left ventricular end-systolic volume; LAVI, left atrial end-systolic volume; EF, ejection fraction; E, peak of early diastolic; A, late diastolic; mitral flow velocities. DT, deceleration time of E-wave; S, pulmonary vein peak velocities systole; D, diastole. pulsed tissue Doppler imaging velocities; Sm, peak systolic; Em, early diastolic velocities; Am, late diastolic velocities.