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Cardiovascular Diabetology

, 11:119

First Online: 03 October 2012Received: 18 August 2012Accepted: 20 September 2012

Abstract

Elevated plasma N-terminal NT-proBNP from the heart as well as white matter hyperintensities WMH in the brain predict cardiovascular CV mortality in the general population. The cause of poor prognosis associated with elevated P-NT-proBNP is not known but WMH precede strokes in high risk populations. We assessed the association between P-NT-proBNP and WMH or brain atrophy measured with magnetic resonance imaging MRI in type 2 diabetic patients, and age-matched controls.

Methods and resultsWe measured P-NT-proBNPng-l in 20 diabetic patients without prior stroke but withn = 10 or withoutn = 10 asymptomatic coronary artery diseaseCAD in order to include patients with a wide-ranging CV risk profile. All patients and 26 controls had a 3D MRI and brain volumesml with WMH and brain parenchymal fractionBPF, an indicator of brain atrophy, were determined.

P-NT-proBNP was associated with WMH in linear regression analysis adjusted for CV risk factorsr = 0.94, p = 0.001 and with BPF in univariate analysisr = 0.57, p = 0.009. Patients divided into groups of increased P-NT-proBNP levels were paralleled with increased WMH volumesgeometric meanSD;2.865.11 ml and 0.762.49 ml compared to patients with low P-NT-proBNP 0.202.28 ml, p = 0.003 and also when adjusted for age, sex and presence of CADp = 0.017. The association was strengthened by CV risk factors and we did not find a common heart or brain specific driver of both P-NT-proBNP and WMH. Patients and particular patients with CAD had higher WMH, however no longer after adjustment for age and sex.

ConclusionP-NT-proBNP was associated with WMH in type 2 diabetic patients, suggesting a linkage between heart and brain disease.

KeywordsType 2 diabetes Plasma NT-proBNP 3-D magnetic resonance imaging White matter hyperintensities Brain parenchymal fraction AbbreviationsCCSAgaston coronary calcium score

BPFBrain parenchymal fraction

CVCardiovascular

CIMTCarotid artery intima media thickness

CAGCoronary angiography

CADCoronary artery disease

LVEFLeft ventricular ejection fraction

MRIMagnetic resonance imaging

MMSEMini Mental Status Examination

MPIMyocardial imaging

P-NT-proBNPN-terminal-proBNP

WMHWhite matter hyperintensities.

Electronic supplementary materialThe online version of this article doi:10.1186-1475-2840-11-119 contains supplementary material, which is available to authorized users.

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Author: Henrik Reinhard - Ellen Garde - Arnold Skimminge - Per Åkeson - Thomas Zoëga Ramsøy - Kaj Winther - Hans-Henrik Parving

Source: https://link.springer.com/article/10.1186/1475-2840-11-119







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