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NT-proBNP, cerebral small vessel disease and cardiac function in patients with a recent lacunar infarct

Abstract

NT-proBNP is produced from both atria and ventricles and it is increased in patients with cardiac disease. NT-proBNP is also associated with cerebral small vessel disease(cSVD) but there are no studies that had carried out a systematic evaluation of cardiac function in this specific setting. We conducted a prospective observational study in 100 patients within 30 days after a recent lacunar infarct by means of brain MRI, 24 h ambulatory blood pressure monitoring, transthoracic echocardiography, and plasmatic NT-proBNP. Global cSVD burden was quantified using a validated visual score (0 to 4) and dichotomized into 2 groups (0–2 or 3–4). Age (73.8 vs 63.5 years) and NT-proBNP (156 vs 76 pg/ml) were increased in patients with SVD 3–4, while daytime augmentation index normalized for the heart rate of 75 bpm (AIx75) (22.5 vs 25.6%) was decreased. The proportion of patients with left atrial enlargement, left ventricular hypertrophy, or septal e′ velocity <7 cm/s was not different between both groups. NT-proBNP was increased in patients with left atrial enlargement (126 vs 88 pg/ml). In multivariate analysis, age (OR 1.129 CI 95% 1.054–1.209), daytime AIx75 (OR 0.91 CI 95% 0.84–0.987,) and NT-proBNP (OR 1.007 CI 95% 1.001-1.012,) were independently associated with cSVD score 3–4. In conclusion, as well as in other patients with cSVD we found an association between NT-proBNP and cSVD. This association was independent of cardiac function.

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Fig. 1: Boxplot.
Fig. 2: Boxplot.
Fig. 3: Boxplot.

Data availability

Data from this study will be available from the corresponding author upon reasonable request.

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Acknowledgements

We thank CERCA Programme/Generalitat de Catalunya for institutional support. We thank Juan Carlos Calvo for his technical assistance.

Author contributions

MGC designed the study, included patients in the study, collected data, and drafted the manuscript. LM, MAF, JJM, SG, and CA included patients and collected data. CM and LC carried out neuroimaging evaluation. PB performed transthoracic echocardiography. ML drawn blood samples and performed ambulatory blood pressure monitoring. MMB performed the statistical analysis. PA carried out blood pressure assessment, analyzed ambulatory blood pressure monitoring, and drafted the manuscript. LM, MAF, JJM, SG, CA, and PB made a critical review of the manuscript.

Funding

This work was supported by a grant from the Fondo de Investigaciones Sanitarias of the Spanish Ministry of Health (PI17/1188). MGC is funded by the Department of Health of the Generalitat de Catalunya (grant SLT008/18/00032) by the call “Acció instrumental: Intensificació de professionals de la salut, modalitat de professionals sanitaris (infermeria i fisioteràpia)”

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Correspondence to Manuel Gómez-Choco.

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The authors declare no competing interests.

Ethical approval

The study was approved by Bellvitge University Hospital clinical research ethics committee with protocol number PR134/17. Written informed consent was obtained from all participants. The investigation conforms to the principles outlined in the declaration of Helsinki.

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Gómez-Choco, M., Mena, L., Font, M.À. et al. NT-proBNP, cerebral small vessel disease and cardiac function in patients with a recent lacunar infarct. J Hum Hypertens (2022). https://doi.org/10.1038/s41371-021-00648-8

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