Abstract
Early detection of asymptomatic left ventricular systolic dysfunction (LVSD) or diastolic dysfunction (DD) in Type II Diabetes Melli- tus patients may prevent complication such as Myocardial infarction. Present study is aimed to study the prediction chances of myocardial infarction in type II Diabetes mellitus patients using co-relation of plasma BNP level with 2-D-ECHO findings. A total of 100 diabetes mellitus type II patients were studied of which 50 DM had evidence of MI and remaining 50 were without any evidence of MI for more than 5 yrs. BNP values were inversely proportional to left ventricular systolic ejection fraction. This correlation was significant (p<0.001). Elevated BNP levels were significantly correlated with presence of Diastolic Dysfunction (p<0.001).In our study the BNP cutoff value of 100pg/ml had a sensitivity of 90%, specificity of 70 %. In patients with only Diabetes, of the 14 patients with elevated BNP levels and normal Ejection Frac- tion, 10 revealed diastolic dysfunction. Of the remaining 4, further follow-up of two patients showed presence of Coronary Artery Disease, indicates that BNP is good investigation for detecting underlying coronary artery disease in high risk population such as Type II Diabetes Mellitus.
Highlights
Discovery of the cardiac peptides in the 1980s renewed the appreciation of the heart as an endocrine organ
It is observed that mean B-type natriuretic peptide (BNP) level (72.18pg/ml) in diabetic patients without any evidence of MI were significantly reduced as compared to mean BNP level (799.02 pg/ml) observed in DM patients associated with symptoms of MI
It is seen that asymptomatic diabetic patients of group A, who were found to have normal left ventricular function on echo but with presence of diastolic dysfunction patients have demonstrated lower BNP level (150.04 pg/ml) as compared to BNP Level (682.54 pg/ml) seen in symptomatic diabetic patients with evidence of MI and difference was found to be statistically significant
Summary
Discovery of the cardiac peptides in the 1980s renewed the appreciation of the heart as an endocrine organ. B-type natriuretic peptide (BNP) is a 32-amino-acid polypeptide secreted by the cardiac ventricles in response to ventricular volume expansion and pressure overload [2, 3, and 4]. It is released in a wide range of cardiovascular disease, including systolic and diastolic left ventricular dysfunction, coronary artery disease, valvular heart disease, acute and chronic right ventricular failure, and left and right ventricular hypertrophy secondary to arterial or pulmonary hypertension. Observational studies have suggested that, when used in conjunction with other clinical information, B
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