Aortic augmentation index is independently associated with N-terminal pro b-type natriuretic peptide in patients with peripheral arterial disease

Shahin, Yousef; Chetter, Ian

Abstract

Objectives: To investigate the relationship of aortic augmentation index (AIx) with N-terminal pro B-type natriuretic peptide (NTproBNP) plasma levels in patients with peripheral arterial disease (PAD) with normal left ventricular (LV) function. Methods: Totally, 31 patients (23 males, mean age 65 ± 7.4) with a confirmed diagnosis of PAD of the lower limbs (ankle-brachial pressure index [ABPI] <0.90 in at least 1 leg) were enrolled in this study. All patients underwent pulse wave analysis by applanation tonometry of the radial artery using the SphygmoCor system and had a measurement of plasma NTproBNP levels.Results: Patients had a mean resting ABPI of 0.62 ± 0.19 and a mean AIx 32.6% ± 6.9. Median (interquartile range) NTproBNP plasma level was 75 (44-210) pg/mL. In a univariate analysis which included age, brachial systolic blood pressure (BSBP), brachial diastolic blood pressure (BDBP), ejection duration index (ED%), heart rate (HR), and NTproBNP, aortic AIx was significantly associated (Spearman rho) with NTproBNP, HR, and ED% (r = .49, P = .006; r = -.72, P = .000, and r = -.42, P = .02, respectively). Multivariate linear regression analysis showed that AIx was associated with NTproBNP (β = 0.38, P = .02) independent of gender, HR, ED%, and use of β-blockers. N-terminal pro B-type natriuretic peptide explained 8% of the variance in aortic AIx, whereas HR explained 15% of the variance. Conclusion: In patients with PAD with normal LV systolic function, AIx is independently associated with NTproBNP. Structural changes in the myocardium might occur due to increased LV afterload as a result of increased wave reflections and arterial stiffness due to atherosclerosis leading to an increase in NTproBNP plasma levels.

Citation

Shahin, Y., & Chetter, I. (2012). Aortic augmentation index is independently associated with N-terminal pro b-type natriuretic peptide in patients with peripheral arterial disease. Vascular and endovascular surgery, 46(8), 648-653. https://doi.org/10.1177/1538574412462634

• Journal Article Type: Article
• Acceptance Date: Oct 8, 2012
• Online Publication Date: Oct 8, 2012
• Publication Date: 2012-11
• Journal: Vascular and Endovascular Surgery
• Print ISSN: 1538-5744
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• Volume: 46
• Issue: 8
• Pages: 648-653
• DOI: https://doi.org/10.1177/1538574412462634
• Keywords: Surgery; Cardiology and Cardiovascular Medicine; General Medicine
• Public URL: https://hull-repository.worktribe.com/output/432589
• Publisher URL: http://journals.sagepub.com/doi/10.1177/1538574412462634