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A novel global strain diastolic index correlates with plasma NT-proBNP levels in asymptomatic hypertensive patients with preserved left ventricular ejection fraction

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Abstract

Background

The strain imaging diastolic index (SI-DI) was reported to be a sensitive marker of regional left ventricular (LV) delayed relaxation induced by ischemia. However, the clinical usefulness of the global SI-DI has not been evaluated. N-terminal pro-brain natriuretic peptide (NT-proBNP) is a sensitive biomarker for the detection of asymptomatic diastolic LV dysfunction. This study investigated the ability of a novel parameter, the global SI-DI, obtained using 2D speckle tracking imaging (2DSI) to correlate with the plasma NT-proBNP levels in asymptomatic hypertensive patients with preserved LV ejection fraction.

Methods

We performed 2D echocardiography and 2DSI in 83 asymptomatic hypertensive patients with preserved ejection fraction (>45 %) and in 37 control subjects. In 2DSI, the LV longitudinal peak strain and the SI-DI of 18 LV segments were measured. NT-proBNP was measured in all subjects. The data were compared between hypertensive patients and normal controls.

Results

The average peak strain and global SI-DI of 18 LV segments were significantly reduced in hypertensive patients compared with control subjects (P < 0.05); however, only the global SI-DI was significantly correlated with log10 NT-proBNP (r = −0.469, P = 0.001). In Pearson’s correlation analyses, log10 NT-proBNP was significantly correlated with E/e′, E/A ratio, early diastolic mitral annular velocity (e′), global peak strain, deceleration time of the E-wave, and LV ejection fraction. In the multiple stepwise regression analysis, the global SI-DI was the strongest independent determinant of log10 NT-proBNP (β = −0.386, P = 0.008).

Conclusions

The global SI-DI derived from 2DSI correlates well with plasma NT-proBNP levels and may have prognostic value in asymptomatic hypertensive patients with preserved ejection fraction.

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Acknowledgments

This work was partially supported by a Grant-in-Aid for Scientific Research (20500427) from the Japan Society for the Promotion of Science (Masao Daimon), partially supported by a Grant-in-Aid for Scientific Research (20231501) from the Ministry of Health, Labour and Welfare (Masao Daimon), and was partially supported by a Grant for Scientific Research (097XDAA00141) from the Department of Health, Taipei City Government (Shuo-Ju Chiang and Betau Hwang). We are grateful to Ms. Mei-Hsiu Yeh and Ms. Maiko Hirano for their research assistance.

Conflict of interest

There is no relationship with any industry.

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Authors and Affiliations

  1. Division of Cardiology, Department of Internal Medicine and Pediatrics, Taipei City Hospital Zhongxiao Branch, National Yang-Ming University, Taipei, Taiwan

    Shuo-Ju Chiang, Mei-Hsiu Yeh & Betau Hwang

  2. Department of Cardiology, Juntendo University School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan

    Shuo-Ju Chiang, Masao Daimon, Sakiko Miyazaki, Yoko Koiso, Hiromasa Suzuki, Katsumi Miyauchi, Bei Yang & Hiroyuki Daida

  3. Department of Cardiology, Kansai Electric Power Hospital, Osaka, Japan

    Katsuhisa Ishii

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  1. Shuo-Ju Chiang
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  2. Masao Daimon
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  3. Katsuhisa Ishii
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Correspondence to Masao Daimon.

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Chiang, SJ., Daimon, M., Ishii, K. et al. A novel global strain diastolic index correlates with plasma NT-proBNP levels in asymptomatic hypertensive patients with preserved left ventricular ejection fraction. J Echocardiogr 10, 56–64 (2012). https://doi.org/10.1007/s12574-012-0122-4

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  • DOI: https://doi.org/10.1007/s12574-012-0122-4

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