Exercise-induced secretion of NT-pro BNP in asymptomatic hypertensive patients with type 2 diabetes mellitus – an early sign of subclinical ventricular dysfunction

Abstract

Background: The association between hypertension (HTN) and type 2 diabetes mellitus (DM) frequently leads to left ventricular diastolic dysfunction (DD). Methods: We aim to test whether DD can readily be unveiled as early as in the subclinical stage in diabetic hypertensive asymptomatic patients, even before echocardiography can do so. We compared the values of NT-pro BNP (as a marker of increased filling pressures) before and after the treadmill stress test in hypertensive patients with and without diabetes mellitus (DM) and normal subjects. All had normal systolic and diastolic functions at rest and after the stress test, according to the recommendations of the ESC. Results: The results from our study showed a significant increase inNT-pro BNP after the stress test, but only in hypertensive patients with diabetes. Conclusion: Compared with echocardiography, measuring the changes inNT-pro BNP after the stress test in hypertensive and diabetic patients with class A heart failure could be a tool for diagnosing DD much earlier in the evolution of the disease. This is an important finding because these patients are difficult to distinguish from those with normal left ventricle function, based only on restingNT-pro BNP or echocardiography. In this way, they can benefit much earlier from specific therapies to mitigate future cardiovascular events.