Possible Mechanisms Underlying Elevated Serum N-Terminal Pro-Brain Natriuretic Peptide in Healthy Japanese Subjects

• Published in: Circulation Reports Vol. 1; no. 9; pp. 372 - 377
• Main Authors: Tomiyama, Hirofumi, Fujii, Masatsune, Yamashina, Akira, Chikamori, Taishiro, Matsumoto, Chisa, Iwasaki, Yoichi, Nakano, Hiroki, Shiina, Kazuki
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Circulation Society 10.09.2019
• Subjects: Cardiac preload/afterload; Cardiac systolic function; Heart Failure; NT-proBNP; Original article; Cardiac systolic function; Cardiac preload/afterload; NT-proBNP
• ISSN: 2434-0790; 2434-0790
• DOI: 10.1253/circrep.CR-19-0057

Background:The precise mechanisms underlying elevation of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) in healthy subjects have not been fully clarified.Methods and Results:In 2,844 Japanese healthy subjects with serum NT-proBNP <125 pg/mL, (1) brachial-ankle pulse wave velocity and (2) second peak of the peripheral systolic blood pressure minus diastolic blood pressure (pulse pressure 2 [PP2]), as markers of cardiac afterload; (3) fibrosis 4 score (FIB-4 score, a marker of liver fibrosis), as a marker of cardiac preload; and (4) ratio of the pre-ejection time to ejection time (PEP/ET), as a marker of cardiac systolic function, were measured. At the first examination, after the adjustments, log-transformed serum NT-proBNP was associated with PP2 and FIB-4 score, but not with PEP/ET. These parameters were successfully measured again after a 3-year interval in 1,978 subjects. On Pearson’s correlation analysis, change in PP2 and FIB-4 score during the study period was significantly correlated with change in serum NT-proBNP (r=0.05, 0.09, respectively; P<0.01).Conclusions:In apparently healthy Japanese subjects, both increased cardiac preload and increased cardiac afterload, but not impaired cardiac systolic function, may be associated with elevated serum NT-proBNP.