Predictive value of HOMAIR indices for severity of left ventricular diastolic dysfunction and NT-proBNP activity

Abstract

Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Academy of Sciences of Moldova Hypertension (HT) and insulin resistance (IR) often coexist and condition LV diastolic function's alteration. Diastolic dysfunction (DD) identifies hypertensives with high cardiovascular risk independent of LV mass and BP level. NT-pro BNP level serve as a diagnostic and prognostic tools in patient with DD. Several studies suggest that DD severity could be interdependent with some biomarkers (HOMAIR, NT-proBNP). Aim To determine if HOMA IR indices could play a predictive role in appreciating severity of LV diastolic dysfunction/ NT-proBNP activity. Methods 101 hypertensive patients (mean age 50.11±0.79 yrs; 48.51% of men, SBP/DBP: 201.31±7.41/106.25±5.54 mmHg, BMI- 29.38±0.22 kg/m2 , HOMA IR - 2.67±0.81) with DD and IR (HOMAIR > 2.5) were enrolled for the study. Ambulatory blood pressure monitoring (ABPM), transthoracic echocardiography (TE), HOMAIR and NT-pro BNP were performed at baseline and after 6, 12- months period of treatment. DD patterns were appreciated according to ASE/EACVI 2016 guideline. NT-proBNP cut-off value was considered > 125 pg/ml (ESC). Correlation analysis was performed using Pearson’s test. The correlation coefficient was considered weak at <0.3, medium-0.3-0.7 and strong > 0.7-1.0. Statistical significance was appreciated at a P-value <0.05 and highly significant at a P-value <0.001. Results The baseline characteristics of bunch are shown in Fig 1. Diastolic dysfunction, HOMA-IR and NT-proBNP levels demonstrated a statistically significant correlation (p< 0.001). A more advanced patterns of diastolic dysfunction demonstrated a particularly strong relationship with higher HOMA-IR and NT-proBNP levels ( Tab. 1). Conclusion In hypertensives with increase in insulin resistance, progression of the left ventricle disorder could develop. The interrelation is in such manner, that the higher is HOMAIR level, the more advanced patterns of diastolic dysfunction and NT-pro BNP activity occure.