Research Article
Relationship between cardio-ankle vascular index and N-terminal pro-brain natriuretic peptide in hypertension and coronary heart disease subjects

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Abstract

Arterial stiffness is an independent predictor for vascular diseases. Cardio-ankle vascular index (CAVI) is a new index of arterial stiffness. N-terminal pro-brain natriuretic peptide (NT-proBNP) is a strong prognostic marker in advanced stage of coronary heart disease (CHD). In the present study, we investigated the relationship between CAVI and NT-proBNP in hypertension and CHD subjects. Five hundred one subjects (male/female, 209/292) from Vascular Medicine of Peking University Shougang Hospital were divided into four groups: healthy group (n = 186), hypertension group (n = 159), CHD group (n = 45), and hypertension with CHD group (n = 111). CAVI was measured using VS-1000 apparatus. Our results showed that CAVI was significantly higher in hypertension subjects with CHD than in healthy and hypertension group, respectively (8.42 ± 1.51 vs. 7.77 ± 1.19; 8.42 ± 1.51 vs. 7.92 ± 1.11; both P < .05). NT-proBNP was significantly higher in hypertension subjects with CHD than in healthy, hypertension, and CHD group, respectively (422.48 ± 761.60 vs. 174.29 ± 415.48; 422.48 ± 761.60 vs. 196.14 ± 299.16; 422.48 ± 761.60 vs. 209.66 ± 242.66; all P < .05). And after log transformation of NT-proBNP, this phenomenon also exists (2.32 ± 0.47 vs. 2.03 ± 0.40; 2.32 ± 0.47 vs. 2.09 ± 0.44; 2.32 ± 0.47 vs. 2.12 ± 0.42; all P < .05). There was positive correlation between log NT-proBNP and CAVI in the entire study group, healthy group, and nonhealthy group (r = 0.235, P < .001; r = 0.184, P = .023; r = 0.237, P < .001; respectively). Multivariate analysis showed that NT-proBNP was an independent associating factor of CAVI in all subjects (β = 0.150, P = .021). Our present study showed that CAVI and NT-proBNP were significantly higher in hypertension subjects with CHD compared with healthy and hypertension groups. There was significant correlation between NT-proBNP and CAVI, which indicates the relationship between arterial stiffness and biomarkers in vascular-related diseases.

Introduction

Arteriosclerosis is the basic pathophysiological change during the development of vascular-related diseases such as hypertension, coronary heart disease (CHD), and metabolic syndrome and so on. Arterial stiffness increasing is the manifestation of arteriosclerosis, and it is a strong predictor of future cardiovascular events and all-cause mortality. Cardio-ankle vascular index (CAVI), a new index of arterial stiffness, is recently developed by measuring of pulse wave velocity (PWV) and blood pressure.1 Recent studies have shown the CAVI is a reliable index of arterial stiffness in many vascular-related diseases.2, 3 Our previous study found that CAVI was significantly higher in hypertension subjects with diabetes mellitus (DM).4

Biomarkers of vascular-related diseases such as N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), and homocysteine (HCY) have involved the pathophysiological development of arteriosclerosis. And NT-proBNP is a controregulatory hormone associated with cardiac remodeling such as left ventricular (LV) hypertrophy and systolic or diastolic dysfunction. Recent studies showed that NT-proBNP is a strong prognostic marker in advanced stages of cardiac diseases like heart failure5 or coronary disease.6 However, there was little research about relationship between CAVI and NT-proBNP in vascular-related diseases. And our present study was to investigate the relationship between CAVI and NT-proBNP in hypertension subjects with CHD.

Section snippets

Subjects

A total of 501 subjects (M/F, 209/292) from department of vascular medicine from January 2012 to December 2013 were enrolled into our study. Subjects with stroke, DM, heart failure, renal function impairment, liver function impairment, systemic inflammatory diseases, infectious disease, or cancer were excluded. They were divided into four groups: healthy group (n = 186), hypertension group (n = 159), CHD group (n = 45), and hypertension with CHD group (n = 111).

Hypertension was defined as blood

Clinical Characteristics of the Study Participants

The clinical characteristics of study participants are shown in Table 1. Our results showed that CAVI was significantly higher in hypertension subjects with CHD than in healthy and hypertension group, respectively (8.42 ± 1.51 vs. 7.77 ± 1.19; 8.42 ± 1.51 vs. 7.92 ± 1.11; both P < .05). NT-proBNP was significantly higher in hypertension subjects with CHD than in healthy, hypertension, and CHD group, respectively (422.48 ± 761.60 vs. 174.29 ± 415.48; 422.48 ± 761.60 vs. 196.14 ± 299.16;

Discussion

Our present study showed that CAVI and NT-proBNP were significantly higher in hypertension subjects with CHD, and NT-proBNP was positively correlated with CAVI in hypertension subjects with CHD.

An increase in arterial stiffness is not only a pathologic status of hypertension and CHD but also a strong predictor for the cardiovascular morbidity and mortality caused by these diseases.7 And it can be measured by PWV, which is considered as the gold standard method suggested by European Society of

Acknowledgments

This work was supported by grants from The Capital Health Research and Development of Special to H.W. (No. 2011-4026-02), the hospital fund of Peking University Shougang Hospital to H.W. (No. 2010-Y002 and 2014-Hospital-Clinical-02) and J.L. (No. 2012Y04), and Shougang Keji Fund (2013 Keguan 20-1).

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  • H.W. and J.L. are equal contributors.

    Disclosures: No conflicts of interest, financial or otherwise, are declared by the authors.

    Ethics approval: From the Ethics Committee of the Health Science Center, Peking University, China.

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