Association Of NT-proBNP Research Articles

1155-P: Association of NT-proBNP and CA125 with Cardiometabolic Markers in Indigenous Argentinean Children Living in the Andes Foothills

1155-P: Association of NT-proBNP and CA125 with Cardiometabolic Markers in Indigenous Argentinean Children Living in the Andes Foothills

Association of nt-probnp and left ventricular ejection fraction and their utility as predictors of in-hospital mortality among heart failure patients admitted in a tertiary hospital in davao city

Association of nt-probnp and left ventricular ejection fraction and their utility as predictors of in-hospital mortality among heart failure patients admitted in a tertiary hospital in davao city

Association of NT-proBNP and sST2 with Left Ventricular Ejection Fraction and Oxidative Stress in Patients with Stable Dilated Cardiomyopathy.

The aim of this study was to analyze the relationship between levels of sST2, NT-proBNP and oxidative stress markers in patients with reduced ejection fraction (HFrEF) due to non-ischemic cardiomyopathy. A total of 88 patients with HFrEF were divided into four groups based on left ventricular ejection fraction (≤25% and >25%) and NYHA functional class (group 1-LVEF > 25% and NYHA class I or II; group 2-LVEF > 25% and NYHA class III or IV; group III-LVEF ≤ 25% and NYHA class I or II; group IV-LVEF ≤ 25% and NYHA class III or IV). In 39 (44.32%) patients LVEF was reduced below 25%, and 22 of them (56.41%) were in NYHA functional class III/IV. Of the 49 (55.68%) patients with LVEF ≥ 25%, only 18.37% were in NYHA functional class III/IV (p < 0.001). Patients with LVEF ≥ 25% had lower levels of NT-proBNP, total oxidant status (TOS), total antioxidant capacity (TAC), and oxidative stress index (OSI). The levels of NT-proBNP but not sST-2 correlated positively with NYHA functional class (p < 0.001) and negatively with LVEF (p < 0.001). The levels of sST-2 were associated with increased TAC (p = 0.009) and uric acid (p = 0.040). These findings indicate that only NT-proBNP was related to the severity of heart failure, whereas sST2 correlated with total antioxidant capacity. Therefore, in stable patients with HFrEF due to dilated cardiomyopathy, sST2 may be an additional biomarker reflecting the redox status, but not the severity of heart failure.

Prognostic and diagnostic significance of the cardiac biomarker NT-proBNP in the perioperative period of vascular surgery procedures

The objective was to study the dynamics of NT-proBNP blood level during the perioperative period of vascular surgery and to study the association of this biomarker level at the stages of treatment with developed cardiovascular complications (CVC).Materials and Methods. The study involved 129 patients aged 66 [61–70] years who underwent elective vascular surgery. NT-proBNP blood level was determined at stages: I – before surgery, II – 24 hours after surgery, III – before discharge from the hospital. Correlation analysis, logistic regression and ROC-analysis were used for data processing.Results. Median NT-proBNP (pg/ml) at stage I was 54[42–215], stage II – 149[63–298] (p1–2 = 0.0001) and stage III – 78[48–288] (p1–3 = 0.037). NT-proBNP blood level at stage I correlated with the biomarker level at stages II (rho = 0.558, p &lt; 0.0001) and III (rho = 0.689, p &lt; 0.0001). The biomarker was associated with CVC at all stages: I – OR 1.0048, 95% CI 1.0021–1.0074, p &lt; 0.0001, AUC 0.825; II – OR 1.0040, 95% CI 1.0020–1.0060, p &lt; 0.0001, AUC 0.820; III – OR 1.0026, 95% CI 1.006–1.0046, p = 0.015, AUC 0.687. At stage I, NT-proBNP &gt; 218 pg/ml was a CVC predictor (sensitivity 82%, specificity 85%), this biomarker level was registered in 30 (23.2%) patients; at stage II, NT-proBNP &gt; 281 pg/ml was associated with CVR (sensitivity 81%, specificity 80%), at stage III NT-proBNP &gt; 158 pg/ml was associated with CCC (sensitivity 79%, specificity 65%).Conclusions. After vascular surgery, the median NT-proBNP value increases significantly, remaining within the reference limits, and does not de[1]crease until the patients discharge from the hospital. The perioperative NT-proBNP dynamics may differ in patients with different initial biomarker levels. In 23.2% of vascular surgical patients, the preoperative NT-proBNP blood level increased to a level of more than 218 pg/ml, indicating CVC risk (very good quality predictor model). After surgery, the level of NT-proBNP associated with CVC (very good quality model) exceeds 281 pg/ml. Prior to discharge of patients from the hospital, the association of NT-proBNP with CVC is characterized by a moderate quality model (AUC 0.687). The prognostic significance of the biomarker at this stage of surgical treatment needs further research.

Association of NTproBNP in metabolic syndrome

Aim: The association between NTpro BNP values and different biochemical and anthropometric parameters of metabolic syndrome patients and non-metabolic syndrome individuals are correlated here. Methods: The research involved 200 people aged 21 to 60 years old (100 control and 100 cases). The following measurements were taken- FBS, SBP, DBP, BMI, and lipid profile. Using multiple regression, we examined the correlation between NTproBNP and metabolic syndrome and non-metabolic syndrome patients. Correlation of Metabolic syndrome parameters with NTproBNP values are done. Result: NT pro BNP values are higher in metabolic syndrome patients in comparison to non-Metabolic syndrome patients. NTproBNP values are positively correlated with SBP, TG, LDL values in metabolic syndrome patients. Conclusion: NT pro BNP values are higher in metabolic syndrome patients in comparison to non-Metabolic syndrome patients.

Abstract 10162: NT-proBNP is Associated with Stroke, Heart Failure Hospitalizations, and Death in Patients with Atrial Fibrillation Without Oral Anticoagulation Regardless of Heart Rhythm

Background: NT-proBNP is elevated in patients with a diagnosis of atrial fibrillation (AF) and associated with risk of stroke and other outcomes. The associations have mainly been studied in patients on oral anticoagulation and not considering if samples were obtained during AF or sinus rhythm. We investigated the association of NT-proBNP with heart rhythm and cardiovascular (CV) events in patients with AF without oral anticoagulation. Methods: Plasma samples were obtained at baseline in 3184 patients with diagnosis of AF (2142 in AF rhythm at blood sampling) receiving aspirin in two multicenter randomized clinical trials with median follow-up 1.2 years (AVERROES) and 3.8 years (ACTIVE A), respectively. NT-proBNP was analyzed using Elecsys electrochemiluminescence immunoassay. Association of NT-proBNP with clinical variables was assessed with multivariable linear regression models. Association with outcomes were estimated with Cox-regression models adjusting for clinical variables. Results: Median age was 71 years, 57.8% were men, and median NT-proBNP 713 ng/L (25 th -75 th percentiles, 282-1388 ng/L). Variables contributing to NT-proBNP level were, in reducing order: AF rhythm (ratio of geometric means 2.9), age, creatinine, and prior heart failure. Levels of NT-proBNP were significantly associated with ischemic stroke (HR 3 rd vs 1 st quartile 2.1, 95%CI 1.5-3.0), heart failure hospitalizations (HR 2.2, 95%CI 1.6-2.9), and CV death (HR 2.4, 95% CI 1.8-3.3), all p&lt;0.001, without significant interaction with AF rhythm. Figure depicts NT-proBNP distribution by rhythm and association with ischemic stroke. Conclusion: In patients with a diagnosis AF, plasma levels of NT-proBNP are three times higher during AF rhythm compared with sinus rhythm. Higher levels of NT-proBNP are independently associated with ischemic stroke, heart failure hospitalizations, and CV death in AF patients without oral anticoagulation treatment, irrespective of heart rhythm.

Prognostic value of NT-proBNP and CA125 across glomerular filtration rate categories in acute heart failure

BackgroundThis study aimed to evaluate whether glomerular filtration rate (eGFR) during admission modifies the predictive value of plasma amino-terminal pro-brain natriuretic peptide (NT-proBNP) and carbohydrate antigen 125 (CA125) in patients hospitalized for acute heart failure (AHF). MethodsWe retrospectively evaluated 4595 patients consecutively discharged after admission for AHF at three tertiary-care hospitals from January 2008 through October 2019. To investigate the effect of kidney function on the association of NT-proBNP and CA125 with 1-year mortality (all-cause and cardiovascular mortality), we stratified patients according to four eGFR categories: <30 mL•min–1•1.73 m–2, 30–44 mL•min–1•1.73 m–2, 44–59 mL•min–1•1.73 m–2, and ≥60 mL•min–1•1.73 m–2. Biomarkers were assessed within the first 24 hours following admission. ResultsAt 1-year follow-up, 748 of 4595 (16.3%) patients died after discharge (of all deaths, 575 [12.5%] were cardiovascular). After multivariate adjustment, both NT-proBNP and CA125 remained independently associated with a higher risk of death when modeled as main effects (P<0.001). However, we found a differential prognostic effect of NT-proBNP across eGFR categories for both endpoints (all-cause mortality, P-value for interaction=0.002; CV mortality, P-value for interaction=0.001). Whereas NT-proBNP was positively and linearly associated with mortality in the subset of patients with normal or mildly reduced eGFR, its predictive ability progressively decreased at the lower extreme of eGFR (<45 mL•min–1•1.73 m–2). In contrast, the association between CA125 and survival remained consistent across all eGFR categories (all-cause mortality, P-value for interaction=0.559; CV mortality, P-value for interaction=0.855). ConclusionsIn patients with AHF and severely reduced eGFR, CA125 outperforms NT-proBNP in predicting 1-year mortality.

Association of NT-ProBNP, Blood Pressure, and Cardiovascular Events: The ARIC Study

BackgroundAlthough intensive blood pressure reduction has cardiovascular benefits, the absolute benefit is greater in those at higher cardiovascular disease (CVD) risk. ObjectivesThis study examined whether N-terminal pro–B-type natriuretic peptide (NT-proBNP) helps identify subjects at higher risk for CVD events across systolic blood pressure (SBP), diastolic blood pressure (DBP), or pulse pressure (PP) categories. MethodsParticipants from the ARIC (Atherosclerosis Risk In Communities) study visit 4 (1996 to 98) were grouped according to SBP, DBP, or PP categories and further stratified by NT-proBNP categories. Cox regression models were used to estimate hazard ratios for incident CVD (coronary heart disease, ischemic stroke, or heart failure hospitalization) and mortality across combined NT-proBNP and/or BP categories, adjusting for CVD risk factors. ResultsThere were 9,309 participants (age: 62.6 ± 5.6 years; 58.3% women) with 2,416 CVD events over a median follow-up of 16.7 years. Within each SBP, DBP, or PP category, a higher category of NT-proBNP (100 to <300 or 300 pg/ml, compared with NT-proBNP <100 pg/ml) was associated with a graded increased risk for CVD events and mortality. Participants with SBP 130 to 139 mm Hg but NT-proBNP ≥300 pg/ml had a hazards ratio of 3.4 for CVD (95% confidence interval: 2.44 to 4.77) compared with a NT-proBNP of <100 pg/ml and SBP of 140 to 149 mm Hg. ConclusionsElevated NT-proBNP is independently associated with CVD and mortality across SBP, DBP, and PP categories and helps identify subjects at the highest risk. Participants with stage 1 hypertension but elevated NT-proBNP had greater cardiovascular risk compared with those with stage 2 SBP but lower NT-proBNP. Future studies are needed to evaluate use of biomarker-based strategies for CVD risk assessment to assist with initiation or intensification of BP treatment.

The Value of NT-proBNP the Follow - up of Children with Dilated Cardiomyopathy

Objectives: To survery the plasma NT-proBNP concentration, the correlation between NT-proBNP concentration and the New York Pediatric Heart Failure Index (NYU PHFI) in children with dilated cardiomyopathy. Comment on the association of NT-proBNP with the level of left ventricular dilatation and systolic function in the follow - up of children with dilated cardiomyopathy. Method: Prospective, descriptive study. Results: At the time of diagnosis, 32 out of 33 patients (97%) had an NTproBNP level higher than 97,5th percentile. The log NT-proBNP was significantly positively correlated with PHFI (r = 0.84; P &lt;0.001). The log NT-proBNP wasalso positively correlated with LVED (r = 0.519; p &lt;0.001), was negatively correlated with LVEF (r = -0.736; p &lt;0.001) and LVFS (r = - 0.737; p &lt;0.001. The initial levels of serum NT-proBNP were not different from three progressed groups. However, at 3 months after diagnosis, the NT-proBNP of the improved group was significantly different from each other. Conclusion: NT-proBNP is an excellentbiomarker used to diagnose and assess cardiac insufficiency inthe follow – up of children with dilated cardiomyopathy.&#x0D; &#x0D;

Investigation of factors related to N-terminal pro-B type natriuretic peptide levels in hemodialysis patients; a single center study

Introduction: Introduction: N-terminal pro-B type natriuretic peptide (NT-proBNP) can be used to diagnose cardiac and renal disease. The association of NT-pro BNP with demographic, clinical and biochemical factors in hemodialysis is unclear. Objectives: This study aimed to examine association of NT-pro BNP and mentioned factors in hemodialysis patients. Patients and Methods: This study was conducted on 78 end-stage renal disease (ESRD) patients under hemodialysis. Demographic data, lipid profile and electrolytes were recorded. NT-proBNP was checked simultaneously and its association with mentioned factors were assessed. Results: The average NT-pro BNP level was 890.52±700.87 pg/mL (range: 0.1-3343 pg/mL). Serum level of NT-pro BNP was statistically in association with total cholesterol (P=0.002; r=-0.348), low density lipoprotein (LDL) (P=0.09; r= -0.292), high density lipoprotein (HDL) (P=0.06; r=-0.310) and serum triglyceride (P=0.018; r=-0.269) while having a direct relationship with serum ferritin (P=0.022; r=0.274), alkaline phosphatase (ALP) (P=0.048; r=0.224) and duration of hemodialysis (P=0.005; r=0.321). Conclusion: Lipid profile and ferritin are associated with NT-pro BNP levels. This can reflect possible prognostic role of NT-proBNP among ESRD patients on hemodialysis.

N-terminal pro-B-type natriuretic peptide and microsize myocardial infarction risk in the reasons for geographic and racial differences in stroke study

BackgroundN-terminal pro B-type peptide (NT-proBNP) has been associated with risk of myocardial infarction (MI), but less is known about the relationship between NT-proBNP and very small non ST-elevation MI, also known as microsize MI. These events are now routinely detectable with modern troponin assays and are emerging as a large proportion of all MI. Here, we sought to compare the association of NT-proBNP with risk of incident typical MI and microsize MI in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study.MethodsThe REGARDS Study is a national cohort of 30,239 US community-dwelling black and white adults aged ≥ 45 years recruited from 2003 to 2007. Expert-adjudicated outcomes included incident typical MI (definite/probable MI with peak troponin ≥ 0.5 μg/L), incident microsize MI (definite/probable MI with peak troponin < 0.5 μg/L), and incident fatal CHD. Using a case-cohort design, we estimated the hazard ratio of the outcomes as a function of baseline NT-proBNP. Competing risk analyses tested whether the associations of NT-proBNP differed between the risk of incident microsize MI and incident typical MI as well as if the association of NT-proBNP differed between incident non-fatal microsize MI and incident non-fatal typical MI, while accounting for incident fatal coronary heart disease (CHD) as well as heart failure (HF).ResultsOver a median of 5 years of follow-up, there were 315 typical MI, 139 microsize MI, and 195 incident fatal CHD. NT-proBNP was independently and strongly associated with all CHD endpoints, with significantly greater risk observed for incident microsize MI, even after removing individuals with suspected HF prior to or coincident with their incident CHD event.ConclusionNT-proBNP is associated with all MIs, but is a more powerful risk factor for microsize than typical MI.

New Insights into Cardiac and Vascular Natriuretic Peptides: Findings from Young Adults Born with Very Low Birth Weight.

In community studies, plasma B-type natriuretic peptide (BNP) is positively associated with cardiovascular disorders. Those born with very low birth weight (VLBW) have increased risk of metabolic and vascular disorders in later life, but plasma concentrations of natriuretic peptides have not been studied. The objectives here were to evaluate BNP and C-type natriuretic peptide (CNP)-a putative marker of vascular risk-in young adults born with VLBW. In all, 220 VLBW cases and 97 matched controls were studied 28 years after birth during a 2-day period at 1 research center. Aminoterminal (NT) products (NTproBNP, NTproCNP) and a range of conventional vascular risk factors including echocardiographic indices were measured along with genetic polymorphisms known to increase plasma NTproBNP. VLBW individuals were smaller, had smaller hearts, reduced stroke volume and endothelial function, and higher systolic blood pressure and arterial elastance. Of the many humoral vascular and metabolic risk factors measured, including NTproBNP, only plasma NTproCNP (higher in VLBW individuals) differed significantly. Across all individuals, associations of NTproCNP with each of 7 conventional risk factors, as well as with arterial elastance, were positive, whereas associations of NTproBNP with risk were all inverse. In multivariate analysis, the genetic variant rs198358 was independently associated with NTproBNP. In young adults at increased risk of cardiovascular disease, higher NTproCNP likely reflects a compensatory vascular response to vascular stress, whereas the negative link with NTproBNP likely reflects beneficial genetic mutations. The ratio of NTproBNP to NTproCNP may provide a novel index of ideal cardiovascular health.

Prospective Validation of a Screening Biomarker Approach Combining Amino-Terminal Pro-Brain Natriuretic Peptide With Galectin-3 Predicts Death and Cardiovascular Events in Asymptomatic Hemodialysis Patients

Cardiovascular (CV) disease is a major cause of death in hemodialysis patients. Biomarkers used to identify high-risk asymptomatic patients would allow early evaluation of cardiac dysfunction and appropriate therapeutic intervention. Amino-terminal pro-brain natriuretic peptide (NT-proBNP) and galectin-3 (Gal-3) may serve this purpose. Plasma levels of NT-proBNP and Gal-3 were measured in 173 patients. Patients were prospectively followed for occurrences of major CV events or death. The association of NT-proBNP and Gal-3 with outcome was analyzed. The prognostic abilities for the combined outcome of Gal-3 and/or NT-proBNP were evaluated. During a median follow-up of 36 months, there were 47 incident outcomes (death and CV events). In the univariable Cox analysis, age, hypertension, albumin, phosphorus levels, and combined elevation of NT-proBNP with Gal-3 above the median (hazard ratio [HR] = 3.65, 95% confidence interval [CI] = 1.45-9.21) were associated with outcomes. In multivariable Cox analysis, both NT-proBNP and Gal-3 values above the median remained associated with outcomes (HR = 3.34, 95% CI = 1.30-8.56). In clinically asymptomatic dialysis patients, combined use of NT-proBNP and Gal-3 may improve risk stratification for death and CV events.

The association of NT-proBNP and asymmetrical dimethylarginine with all-cause mortality in long-term geriatric care patients

The association of NT-proBNP and asymmetrical dimethylarginine with all-cause mortality in long-term geriatric care patients

Association of NT-proBNP and interleukin-17 levels with heart failure in elderly patients.

Pro-B-type natriuretic peptide (NT-proBNP) and interleukin-17 (IL-17) are involved in the pathophysiological processes of heart failure; however, the exact role of IL-17 is not clear. We explored the relationship between IL-17 and NT-proBNP, as a clinical parameter, in heart failure. The whole blood IL-17 and NT-proBNP levels and the readmission rates in 70 patients with chronic heart failure class III or IV according to the New York Heart Association and 35 patients with normal heart function (control group) were measured and compared. The left ventricle ejection fractions (LVEFs) and NT-proBNP and IL-17 levels in cardiac functional class III (40.38 ± 4.76%, 7780 ± 6393 pg/mL, 8.65 ± 3.05 pg/mL, respectively) and class IV (31.59 ± 4.31%, 13,704 ± 10,945, 21.10 ± 10.60 pg/mL, respectively) were higher than those in the control group (61.27 ± 5.66%, 420 ± 256 pg/mL, 3.53 ± 2.05 pg/mL, respectively). Compared to the cardiac functional class IV, class III showed significantly higher values for LVEF and NT-proBNP and IL-17 levels (P < 0.05). The readmission rates of the patients in cardiac functional class III at 3 and 6 months (15.7 and 34.4%, respectively) and cardiac functional class IV at 3 and 6 months (39.5 and 76.3%, respectively) were significantly higher than those in the control group (0 and 5.7%, respectively) (P < 0.05). The NT-proBNP and IL-17 levels increased as the heart function worsened. NT-proBNP and IL-17 may play essential roles in the process of heart failure.

N-terminal pro-B-type natriuretic peptide and the risk of stroke and transient ischaemic attack: the Rotterdam Study.

Amino-terminal pro-B-type natriuretic peptide (NT-proBNP) is a predictor of heart disease. It has also been related to stroke, but its association with transient ischaemic attacks (TIAs) is unclear. Moreover, it is unknown how clinical heart disease influences this relation. Within the prospective population-based Rotterdam Study, the association of NT-proBNP with stroke and TIA was examined and the role of heart disease on this association was investigated. NT-proBNP was measured in 1997-2001 in 5611 participants (mean age 68.7years; 57.7% women) without a history of stroke, TIA or heart failure. Follow-up for stroke and TIA finished in 2012. Models were adjusted for age and cardiovascular risk factors, and were stratified by sex. During 22058 person-years 195 men suffered a stroke and 118 a TIA. During 31825 person-years 230 women suffered a stroke and 187 a TIA. Higher NT-proBNP was associated with a higher risk of stroke in men [hazard ratio (HR) per SD increase 1.50; 95% confidence interval (CI) 1.29-1.76] and in women (HR 1.24; 95% CI 1.05-1.46). Associations with TIA were only present in women (HR 1.51; 95% CI 1.26-1.82) but not in men (HR 1.02; 95% CI 0.83-1.26). Excluding persons with a history of clinical coronary heart disease, heart failure or atrial fibrillation and censoring for clinical heart disease during follow-up did not change the associations. Higher NT-proBNP is associated with incident stroke in men and women and with incident TIA only in women. These associations are independent of clinical heart disease preceding cerebrovascular disease.

Abstract 16662: GDF-15: Association With Pulmonary Hemodynamic Indices and Reduction With Serelaxin in Acute Heart Failure

Background: Growth differentiation factor 15 (GDF-15) appears to have a role in regulating inflammation and apoptosis and is up-regulated following injury to the liver, kidney, heart and lung. Elevated baseline (BL) levels of GDF-15 and increases over time have been shown to be associated with adverse events in heart failure (HF). GDF-15 was decreased following LVAD implantation and cardiac unloading in end stage HF. As previously reported, serelaxin improved Pulmonary Capillary Wedge Pressure (PCWP), mean Pulmonary Artery Pressure (mPAP), and Pulmonary Vascular Resistance (PVR) during a 20 h infusion period (all p&lt;0.005 vs. placebo [PBO]). A post-hoc analysis was performed to explore serelaxin effects on GDF-15 in acute HF (AHF) and whether GDF-15 is associated with pulmonary hemodynamics. Methods: Following serelaxin (30 ug/kg/d) or PBO infusion for 20 h in AHF patients, PCWP, mPAP, PVR, NTproBNP (Roche Diagnostics) and GDF-15 (pre-commercial kit, Roche Diagnostics) were measured in 32 serelaxin and 31 PBO treated patients. The effect of serelaxin on GDF-15 and NTproBNP was analyzed and the potential association of GDF-15 or NTproBNP with selected hemodynamic indices was explored combining treatment data from the two treatment arms. Results: Following the 20 h infusion period, serelaxin reduced GDF-15 vs BL (BL median 3192 pg/ml) by 16% (serelaxin vs PBO p=0.021) and reduced NTproBNP (BL median 3262 pg/ml) by 13% (serelaxin vs PBO p=0.021). GDF-15 at BL and 20 h was significantly associated with BL and 20 h NTproBNP (both p&lt;0.001), mPAP (both p&lt;0.025), and PVR (both p&lt;0.001). At 20 h GDF-15 and PCWP were significantly associated (p&lt;0.02) but their association at BL was not statistically significant (p=0.70). The association of NTproBNP at BL and 20 h was not statistically significant for BL or 20 h PCWP, mPAP or PVR (all p &gt;0.05). Conclusions: In this small invasive hemodynamic study in patients with AHF, serelaxin significantly reduced GDF-15 and NTproBNP and had favorable effects on pulmonary hemodynamics. GDF-15 levels at BL and 20 h showed a strong correlation with BL and 20 h values of mPAP and PVR. Additional studies measuring GDF-15 levels in acute HF patients with pulmonary congestion appear warranted.

Association of N-terminal pro-brain natriuretic peptide and hemodynamic parameters measured by impedance cardiography in patients with essential hypertension

The aim of this study was to evaluate the association of NT-proBNP with clinical and hemodynamic assessment in 156 patients with arterial hypertension. NT-proBNP correlated positively with, i.e. age (r = 0.310, p = 0.00008), mean blood pressure (MBP; r = 0.199, p = 0.0136), Heather index (HI; r = 0.375, p < 0.00001) and negatively with thoracic fluid content (TFC; r = −0.300, p = 0.0002). The patients with higher NT-proBNP were older (46.1 versus 40.6 years, p = 0.001), with higher MBP (102.6 versus 98.5 mm Hg, p = 0.0043), HI (14.54 versus 11.93 Ohm s2, p = 0.009) and lower TFC (27.5 versus 29.4 1/kOhm, p = 0.0032). The independent predictors of higher NT-proBNP were: age, MBP and HI.

Abstract MP27: Cardiovascular Biomarkers and MRI-defined Small Vessel Disease of the Brain in the Atherosclerosis Risk in Communities (ARIC) Study

Background: Cerebrovascular and cardiovascular disease share common risk factors. Thus, biomarkers associated with subclinical cardiac injury may also be associated with silent cerebral injury. We hypothesized that levels of N-terminal brain natriuretic peptide (NT-proBNP) and cardiac troponin T measured with a highly sensitive assay (hs-cTnT) are associated with silent brain infarcts (BI) and white matter lesions (WML) on magnetic resonance imaging (MRI) in the Atherosclerosis Risk In Communities (ARIC) study. Methods: Brain MRI was performed at ARIC visit 3 (1993-1995) on 1920 participants. NT-proBNP and hs-cTnT were measured in all individuals at ARIC visit 4 (1996-1998). A subset (N=1112) of those individuals who had the initial MRI at Visit 3, had a follow up MRI in 2004-2006. We analyzed the association of NT-proBNP and hs-cTnT with the presence of MRI defined BI and WML on the initial MRI and on the follow-up MRI in participants without coronary heart disease and stroke. BI was defined as an area of abnormal signal intensity in a vascular distribution, ≥ 3 millimeters in size, and without mass effect. WML were estimated as the total volume of periventricular and subcortical white matter-signal abnormality. Results: In the adjusted model, individuals in the highest NT-proBNP quartile had significantly more BI and WML on the baseline MRI and more incident BI and WML progression on the follow up MRI when compared to the lowest quartile (Table). In the same model, individuals in the highest hs-cTnT category had significantly more BI and WML on the initial MRI and more WML progression on the follow up MRI when compared to the lowest category. Incident BIs were significantly more common in the 0.009 to ≤0.013 μg/L troponin category but not in the highest one, when compared to the lowest category (Table). Conclusion: NT-proBNP and hs-cTnT are independently associated with silent MRI-defined BI and WML suggesting that biomarkers for subclinical cardiac injury may also be useful to identify individuals with subclinical cerebral injury.

N-terminal Prohormone B-type Natriuretic Peptide and Cardiovascular Function in Africans and Caucasians: The SAfrEIC Study

This study compared NT-proBNP levels and the association with cardiovascular markers between Africans and Caucasians from South Africa. This cross-sectional study involved 201 Africans and 255 Caucasians from the North West province, South Africa. Serum NT-proBNP concentrations, blood pressure, pulse wave velocity and arterial compliance were measured. NT-proBNP levels were significantly higher (P<0.001) in Africans than Caucasians, also after adjusting for gender, body mass index (BMI) and pulse wave velocity (P=0.008). This significant difference became borderline significant after adjusting for systolic blood pressure (SBP) (P=0.060), and non-significant after adjusting for arterial compliance (P=0.35). In single regression, a significant positive correlation of NT-proBNP with SBP (r=0.26; P<0.001) and pulse pressure (PP) (r=0.28; P<0.001) were shown for Africans only. After multiple adjustments, the associations of NT-proBNP with SBP and PP remained significant in Africans (SBP: β=0.187, P<0.01; PP: β=0.234, P<0.001), with no significant associations in Caucasians. NT-proBNP levels were higher in Africans than Caucasians, independently of BMI and gender. This difference was partly driven by higher SBP and lower arterial compliance in Africans. NT-proBNP was persistently associated with SBP and PP in Africans, but not in Caucasians. These associations may suggest early vascular changes contributing to cardiac alterations in Africans.