Beyond Heart Failure: Role of NT-Pro-BNP in Diabetes Mellitus Patients with Preserved Ejection Fraction.

Q2 Medicine
S S Ramaprabha, Hariharan Alexander, Josephine Latha, Pradipta Kumar Mohanty
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引用次数: 0

Abstract

Background: Despite advancements in medical care, including coronary interventions and medications, cardiovascular-related mortality and morbidity remain disproportionately high among patients with diabetes mellitus. A significant factor contributing to this issue is the presence of asymptomatic macrovascular and microvascular angiopathies in many diabetic patients. These vascular complications are often detected at later stages, resulting in the failure of treatment strategies to effectively prevent the progression of heart failure and mitigate worsening conditions. Given this background, our research aims to explore the potential of the biochemical marker NT-pro-BNP (N-terminal pro b-type natriuretic peptide) in the early detection of left ventricular diastolic dysfunction in diabetic patients who maintain a preserved ejection fraction. Left ventricular diastolic dysfunction is a condition where the left ventricle has difficulty relaxing and filling with blood, which can precede the development of heart failure. Identifying this dysfunction early could be crucial in preventing major adverse cardiac events (MACE) such as heart attacks, stroke, and cardiovascular-related death. The focus of our study is to determine whether NT-pro-BNP, which is typically elevated in heart failure, can serve as an early marker for diastolic dysfunction in this specific patient population. By identifying diabetic patients at risk earlier, interventions could be tailored more effectively, potentially improving outcomes and reducing the incidence of severe cardiovascular events.

Study population and methods: This study was conducted at a tertiary care medical care hospital in Madurai, Tamil Nadu, India, with a sample population of 500 patients who had preserved ejection fraction. The participants were divided into two groups: 169 diabetic patients and 150 non-diabetic patients. As part of the baseline assessment, routine clinical chemistry analysis and 2D echocardiograms were performed. Additionally, the biomarker NT-pro-BNP, which is associated with heart failure, was measured using the electrochemiluminescence method.

Result: Among the diabetes and non-diabetes groups, the biomarker NT-pro-BNP were significantly different and the serum concentration of NT-pro-BNP was found to be higher in poor glycemic control type 2 diabetes mellitus patients. Serum NT-pro-BNP screening and 2D echocardiogram showed the best predictor of left ventricular diastolic dysfunction and hospital stay due to major adverse cardiac events in type 2 diabetes mellitus patients.

Conclusion: Our study highlights the clinical significance of NT-pro-BNP among (left ventricular diastolic dysfunction) type 2 diabetes mellitus with preserved ejection fraction > 60 %.

超越心力衰竭:NT-Pro-BNP在保留射血分数的糖尿病患者中的作用。
背景:尽管包括冠状动脉介入治疗和药物治疗在内的医疗保健取得了进步,但糖尿病患者的心血管相关死亡率和发病率仍然高得不成比例。造成这一问题的一个重要因素是在许多糖尿病患者中存在无症状的大血管和微血管病变。这些血管并发症通常在晚期才被发现,导致治疗策略失败,无法有效预防心力衰竭的进展和减轻病情恶化。在此背景下,我们的研究旨在探索生物化学标志物NT-pro-BNP (n -末端前b型利钠肽)在保持射血分数的糖尿病患者左室舒张功能障碍早期检测中的潜力。左心室舒张功能障碍是左心室难以放松和充血的一种情况,这可能先于心力衰竭的发展。早期识别这种功能障碍对于预防心脏病发作、中风和心血管相关死亡等主要心脏不良事件(MACE)至关重要。我们研究的重点是确定NT-pro-BNP是否可以作为这一特定患者群体舒张功能障碍的早期标志,它在心力衰竭中通常升高。通过早期识别有风险的糖尿病患者,干预措施可以更有效地定制,可能改善结果并减少严重心血管事件的发生率。研究人群和方法:本研究在印度泰米尔纳德邦马杜莱的一家三级医疗保健医院进行,样本人群为500名保留射血分数的患者。参与者被分为两组:169名糖尿病患者和150名非糖尿病患者。作为基线评估的一部分,进行常规临床化学分析和二维超声心动图。此外,使用电化学发光法测量与心力衰竭相关的生物标志物NT-pro-BNP。结果:糖尿病组与非糖尿病组生物标志物NT-pro-BNP差异有统计学意义,血糖控制较差的2型糖尿病患者血清NT-pro-BNP浓度较高。血清NT-pro-BNP筛查和二维超声心动图显示2型糖尿病患者左室舒张功能障碍和主要心脏不良事件导致的住院时间的最佳预测指标。结论:本研究强调了nt -亲bnp在2型糖尿病患者(左室舒张功能不全)中保留射血分数bbb60 %的临床意义。
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CiteScore
2.30
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