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NT-proBNP is associated with SYNTAX score and aortic distensibility in patients with stable CAD

NT-proBNP-Spiegel ist mit SYNTAX-Score und Aortendehnbarkeit bei Patienten mit stabiler koronarer Herzkrankheit verknüpft

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Abstract

Objective

A high N-terminal pro-brain natriuretic peptide (NT-proBNP) level provides significant prognostic information on patients with coronary artery disease (CAD). It is unclear whether aortic distensibility (AD), which reflects the aortic stiffness, and the extent and complexity of CAD, assessed with the SYNTAX score (SS), affect the secretion of NT-proBNP in stable CAD. We aimed to investigate the relationship between NT-proBNP levels and AD as well as with the extent and complexity of CAD in stable CAD patients.

Methods

The study included 411 patients with stable CAD (mean age = 61.7 ± 9.9 years, male/female = 247/164). The patients were divided into two groups according to the median NT-proBNP value (NT-proBNPlow group < 114 pg/ml and NT-proBNPhigh group ≥ 114 pg/ml). AD was calculated from the echocardiographically derived ascending aorta diameters and hemodynamic pressure measurements. Coronary angiography was performed and SS was determined in all patients. NT-proBNP and other biochemical markers were measured in all subjects.

Results

The AD and ejection fraction values of the NT-proBNPhigh group were lower and their SS levels were higher compared with those from the NT-proBNPlow group (p < 0.05, for all). The NT-proBNP level was independently associated with AD (β = -0.378, p < 0.001), SS (β = 0.262, p < 0.001), and ejection fraction (β = − 0.295, p < 0.001) on multiple linear regression analysis.

Conclusion

NT-proBNP was independently associated with an impaired elastic property of the aorta and with the extent and complexity of CAD as well as with left ventricular systolic dysfunction.

Zusammenfassung

Ziel

Ein hoher Spiegel an NT-proBNP („N-terminal pro-brain natriuretic peptide“) liefert bei Patienten mit koronarer Herzkrankheit (KHK) wichtige Informationen zur Prognose. Unklar ist, ob die Aortendehnbarkeit (AD), welche die Aortensteifigkeit widerspiegelt, sowie das mit dem SYNTAX-Score (SS) bestimmte Ausmaß und die Komplexität der KHK Einfluss auf die Sekretion von NT-proBNP bei stabiler KHK haben. Ziel der Studie war es, den Zusammenhang zwischen NT-proBNP-Spiegeln einerseits und AD sowie Ausmaß und Komplexität der KHK andererseits bei stabiler KHK zu untersuchen.

Methoden

Die Studie umfasst 411 Patienten mit stabiler KHK (Durchschnittsalter: 61,7 ± 9,9 Jahre, m/w: 247/164). Die Patienten wurden je nach Mittelwert für NT-proBNP in 2 Gruppen unterteilt (NT-proBNPlow-Gruppe < 114 pg/ml und NT-proBNPhigh-Gruppe ≥ 114 pg/ml). Die AD wurde aus den echokardiographisch ermittelten Durchmessern der Aorta ascendens und hämodynamischen Druckmessungen berechnet. Bei allen Patienten wurde eine Koronarangiographie durchgeführt und der SS ermittelt. NT-proBNP und andere biochemische Marker wurden bei sämtlichen Teilnehmern bestimmt.

Ergebnisse

Die Werte für die AD und die Ejektionsfraktion waren in der NT-proBNPhigh-Gruppe niedriger und deren SS-Werte höher als in der NT-proBNPlow-Gruppe (p < 0,05 für alle). Der NT-proBNP-Spiegel war in der multiplen linearen Regressionsanalyse unabhängig mit der AD (β = −0,378; p < 0,001), SS (β = 0,262; p < 0,001) und der Ejektionsfraktion (β = − 0,295; p < 0,001) verknüpft.

Schlussfolgerung

NT-proBNP war unabhängig mit eingeschränkten elastischen Eigenschaften der Aorta sowie dem Ausmaß und der Komplexität der KHK verknüpft, ebenso wie mit einer linksventrikulären systolischen Dysfunktion.

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Conflict of interest

On behalf of all authors, the corresponding author states that there are no conflicts of interest.

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Authors and Affiliations

  1. Adana Numune Training and Research Hospital, Department of Cardiology, Adana, Turkey

    D.Y. Şahin MD, M. Gür, Z. Elbasan, N.Y. Koyunsever, C. Türkoğlu, S. Akyol, A. Yıldırım, G. Gözübüyük, B. Özaltun & M. Çaylı

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  1. D.Y. Şahin MD
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  2. M. Gür
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  3. Z. Elbasan
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  7. A. Yıldırım
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Correspondence to D.Y. Şahin MD.

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Şahin, D., Gür, M., Elbasan, Z. et al. NT-proBNP is associated with SYNTAX score and aortic distensibility in patients with stable CAD. Herz 38, 922–927 (2013). https://doi.org/10.1007/s00059-013-3767-5

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  • DOI: https://doi.org/10.1007/s00059-013-3767-5

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