Segmental arterial stiffness in relation to B-type natriuretic peptide with preserved systolic heart function

PLoS One. 2017 Sep 18;12(9):e0183747. doi: 10.1371/journal.pone.0183747. eCollection 2017.

Abstract

Background: Central arterial stiffness has been shown to play a key role in cardiovascular disease. However, evidence regarding such arterial stiffness from various arterial segments in relation to B-type natriuretic peptide (BNP) remains elusive.

Methods: A total of 1255 participants (47.8% men; mean age: 62.6 ± 12.3 [SD] years) with preserved left ventricular function (ejection fraction ≥50%) and ≥1 risk factors were consecutively studied. Arterial pulse wave velocity (PWV) by automatic device (VP-2000; Omron Healthcare) for heart-femoral (hf-PWV), brachial-ankle (ba-PWV), and heart-carotid (hc-PWV) segments were obtained and related to BNP concentrations (Abbott Diagnostics, Abbott Park, IL, USA).

Results: Subjects in the highest hf-PWV quartile were older and had worse renal function and higher blood pressure (all P < 0.05). Elevated PWV (m/s) was correlated with elevated BNP (pg/ml) (beta coefficient = 19.3, 12.4, 5.9 for hf-PWV, ba-PWV, hc-PWV respectively, all p < 0.05). After accounting for clinical co-variates and left ventricle mass index (LVMI), both hf-PWV and ba-PWV were correlated with higher BNP (beta coefficient = 8.3, 6.4 respectively, P < 0.01 for each). Adding both hf-PWV and ba-PWV to LVMI significantly expanded ROC in predicting abnormal BNP>100 pg/ml (both P < 0.01), but only hf-PWV presented significant integrated discrimination improvement to predict risk for BNP concentrations (0.7%, P = 0.029).

Conclusion: A significant segmental PWV associated with biomarker BNP concentrations suggests that arterial stiffness is associated with myocardial damage.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Pressure*
  • Cardiomyopathies* / blood
  • Cardiomyopathies* / physiopathology
  • Female
  • Humans
  • Kidney Function Tests
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood*
  • Stroke Volume*
  • Vascular Stiffness*

Substances

  • Natriuretic Peptide, Brain

Grants and funding

This research supported by Ministry of Science and Technology (Taiwan) (NSC-101-2314-B-195-020, NSC103-2314-B-010-005-MY3, 103-2314-B-195-001-MY3, 101-2314-B-195 -020 –MY1, MOST 103-2314-B-195-006-MY3, NSC102-2314-B-002-046-MY3), and funds from Mackay Memorial Hospital (10271, 10248, 10220, 10253, 10375, 10358,E-102003).