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Echocardiographic analysis of increased natriuretic peptides plasma levels in patients with hypertension and metabolic syndrome

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ŠPÁC Jiří NĚMCOVÁ Helena SOUČEK Miroslav

Rok publikování 2009
Druh Konferenční abstrakty
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
Popis Aim of the study was the comparison of natriuretic peptides (NP) and type of left ventricular remodelation with the help of echocardiography (echo) for the determination of diastolic left ventricular (LV) dysfunction in patients (pts) with hypertension (HT) and metabolic syndrome( MS) Methods: We have evaluated plasma levels of BNP and NT pro BNP in 141 pts with HT of 1st degrese with MS (group A, mean age 53,6 years, BP 140/93,5 mmHg, BMI 35,4) with normal renal function and without sign sof ischemic heart disease with normal LV systolic function. Echo included 2-D imaging of the LV with evaluation of ejection fraction (EF), left atrial (LA), pulsed doppler assessment of transmitral blood flow velocities (Wales E,A) and pulsed doppler imaging (TDI) of mitral anulus motions (Em, Am, Sm) Results: We have found different levels of BNP, NT pro BNP in pts with LV hypertrophy and those with normal LV mass (134,0 resp 311 pg/ml agains 64,0 resp 69 pg/ml, p < 0,001) The highest BNP resp NT pro BNP were in the group of 25 pts with concentric LV hypertrophy (150 resp 335 pg/ml.In 30 pts with eccentic LV hypertrophy (117 resp 287 pg/ml. In the group of asymetric LV hypertrophy there was no diference in comparison with the group of normal LV parametrs. NP levels have correlated with the occurence of more severe forms of diastolic dysfunction with E/Em ratio, reflecting higher filling pressures of LV (r=0,808 for NT pro BNP resp. 0,786 for BNP, p < 0,001) Conclusion: NP evaluation seems to be applicable for risk stratification of pts with HT and MS where the occurence of more severe forms of diastolic dysfunction reaches 30%. NP are not useful for the detection of mild LV dysfunction in asymptomatic pts and are able to reveal only severe forms of LV diastolic dysfunction. .
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