Association of N-terminal Pro B-type Natriuretic Peptide with Asymptomatic Left Ventricular Dysfunction in Patients of Type 2 Diabetes Mellitus

Abstract

Abstract Objectives: Patients with type 2 diabetes mellitus (T2DM) are known to have an increased risk of developing cardiovascular disease. Increased circulating N-terminal pro B-type natriuretic peptide (NT-proBNP) levels in patients with asymptomatic and symptomatic ventricular dysfunction are demonstrated and therefore can be used as a potential marker for early diagnosis and treatment. Hence, this study was undertaken to determine serum NT-proBNP levels and to explore the association of serum NT-proBNP levels with asymptomatic left ventricular dysfunction (ALVD) in patients of T2DM. Materials and Methods: This hospital-based cross-sectional study was carried out in a total of 85 patients of T2DM without any overt heart disease. Serum NT-proBNP was measured by electrochemiluminescence method. Echocardiography was performed to assess the left ventricular (LV) function in all the study participants. All statistical procedures were performed using SPSS software. Results: Out of the 85 type 2 diabetic participants, 15 (17.6%) were diagnosed with ALVD. Serum NT-proBNP levels in type 2 diabetic patients with ALVD were significantly higher than in T2DM patients with normal LV function (P = 0.001). The area under the receiver operating characteristic curve for NT-proBNP to separate normal versus abnormal ventricular function was 0.95 in Type 2 diabetic patients. Serum NT-proBNP at a cutoff point of 127.65 pg/ml showed 86.7% sensitivity and 97.1% specificity for the detection of ALVD in T2DM patients. Conclusion: Secretion of NT-proBNP is found to be increased in T2DM patients with ALVD and therefore may be a simple screening tool to select diabetic patients with ALVD requiring further examination with echocardiography.