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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThis article reviews data from the Hoorn Study, which prospectively investigated whether B-type natriuretic peptide levels in a nonheart failure range predict left ventricular (LV) mass, or LV systolic and diastolic function in individuals with and without type 2 diabetes mellitus.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EPrevention \u0026amp; Screening\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Endocrinology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHeart FailureDiabetes Mellitus\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EIndividuals with type 2 diabetes mellitus (T2DM) have an increased risk of developing heart failure (HF) and a worse prognosis if they already have HF. B-type natriuretic peptide (BNP) is a marker for HF\u2014patients with nonsystolic HF have significantly (p\u0026lt;0.001) lower BNP levels than those with systolic HF [Maisel J et al. \u003Cem\u003EJ Am Coll Cardiol\u003C\/em\u003E 2003].\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EBNP levels that are well below current thresholds that are used to diagnose HF (\u0026lt;100 pg\/mL) have been associated with increases in left ventricular (LV) mass and deterioration of LV systolic and diastolic function and can predict HF and cardiovascular disease (CVD) mortality [Wang TJ et al. \u003Cem\u003EN Eng J Med\u003C\/em\u003E 2004]. BNP\u0027s association with LV mass and markers of LV diastolic function appears to be particularly strong in individuals with T2DM [Van den Hurk K et al. \u003Cem\u003EEur J Heart Fail\u003C\/em\u003E 2010].\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EMarieke H. Kroon, VU Medical Center, Amsterdam, The Netherlands, reviewed data from the Hoorn Study, which prospectively investigated whether BNP levels in a nonheart failure range predict LV mass, or LV systolic and diastolic function in individuals with and without T2DM.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EParticipants with atrial fibrillation, wall movement abnormalities, and moderate or severe aortic or mitral valve disease were excluded from this study. Plasma BNP (pmol\/L) levels were measured, and 2D echocardiograms were performed at baseline (2000\u20132001). Follow-up was 8 years later. The 2D echocardiograms were used to measure LV mass index (LVMI, g\/m\u003Csup\u003E2\u003C\/sup\u003E), ejection fraction (% EF, systolic function), and left atrial volume index (LAVI, mL\/m\u003Csup\u003E2\u003C\/sup\u003E, diastolic function). Linear regression analyses, adjusted for gender, age, baseline heart function, use of antihypertensive medication, body mass index (BMI), and heart rate (HR), were performed to investigate the association of BNP with LVMI and of LV systolic with diastolic function. In case of significant effect modification (p\u0026lt;0.10), the linear regression coefficients for individuals with and without T2DM were reported separately.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EOf the 796 participants who had baseline echocardiograms (baseline age 66 years; 32% with T2DM), 301 were available for the follow-up examination. Blood pressure levels were lower in T2DM patients at baseline. LV systolic function (% EF) and BNP were not significantly associated with either T2DM or non-T2DM patients when adjusted for age, gender, baseline EF, use of antihypertensives, BMI, and HR. However, this association was significant (p\u0026lt;0.05) when the total population was considered (\u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E). LV diastolic function (LAVI) and BNP levels were significantly (p\u0026lt;0.05) associated with T2DM and non-T2DM patients. LV mass (LVMI) and BNP level were significantly (p\u0026lt;0.05) associated in T2DM but not non-T2DM patients. The increase in LVMI was greater among those with higher baseline BNP, and the association was stronger among patients with T2DM. In patients without T2DM, the association was explained by baseline LVMI, BMI, and use of antihypertensives; in the T2DM patients, the association was independent. Regardless of T2DM status, a 10-pmol\/L higher baseline BNP was associated with a 2.7% lower EF and a 5.0-mL\/m\u003Csup\u003E2\u003C\/sup\u003E higher LAVI at follow-up.\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/11530\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/11530\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/11530\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-7\u0022 class=\u0022first-child\u0022\u003ELV Function.\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-10\u0022\u003EThese results suggest that slightly elevated BNP levels are associated with changes in LV systolic and diastolic function. This association was not dependent on T2DM status. Only in T2DM patients were higher BNP levels associated with increase in LV mass. Thus, the presence or absence of T2DM should be taken into account if BNP levels are used to assess CVD risk.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2010 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/10\/9\/24.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzmnw3\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzmnw3\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}