Impaired diastolic function and elevated Nt-proBNP levels in type 1 diabetic patients without overt cardiovascular disease.

摘要

Diabetic cardiomyopathy is an important complication of type 1 diabetes mellitus. Diastolic heart failure is an early manifestation of diabetic cardiac disease. Nt-proBNP is a valuable marker of ventricular dysfunction. The aim of this study was to determine Nt-proBNP concentrations in type 1 diabetic patients and determine their relationship with ventricular diastolic dysfunction (DD) and carotid artery intima media thickness (CIMT) measurements. Sixty-seven type 1 diabetic patients (30.2?±?8.0?years; W/M: 24/43) without known cardiovascular disease and 48 healthy controls (30.5?±?6.4?years; W/M: 19/29) were recruited. Nt-proBNP levels were measured. Conventional and tissue Doppler echocardiography were used to evaluate left ventricular diastolic function and CIMT. Nt-proBNP in diabetic patients was significantly higher than in controls (38?±?34.8 vs. 15.1?±?12.7?pg/ml) (P?=?0.004). Ea level was higher (12.3?±?3 vs. 10.3?±?4?cm/s, P?=?0.003) and E/Ea ratio was lower in patients (6.6?±?2.5 vs. 9.7?±?5.9, P?=?0.001) compared with controls. Ratio of DD was higher in patients than controls (11.1 vs. 2.1%, P?=?0.01). CIMT measurements in diabetic patients were higher than controls (0.54?±?0.11 vs. 0.48?±?0.05?mm, P?=?0.02). Logistic regression revealed age and HbA1c to be independently associated with the presence of DD. Nt-proBNP levels are elevated in type 1 diabetic patients without overt cardiovascular disease and the presence of DD is increased in diabetic patients in comparison with controls. Nt-proBNP levels do not seem to be related to the presence of DD and subclinical atherosclerosis in this group of patients.