ESC Heart Failure (Oct 2024)

Reservoir‐excess pressure parameters are independently associated with NT‐proBNP in older adults

  • Kunihiko Aizawa,
  • Alun D. Hughes,
  • Francesco Casanova,
  • Kim M. Gooding,
  • Phillip E. Gates,
  • David M. Mawson,
  • Jennifer Williams,
  • Isabel Goncalves,
  • Jan Nilsson,
  • Faisel Khan,
  • Helen M. Colhoun,
  • Carlo Palombo,
  • Kim H. Parker,
  • Angela C. Shore

DOI
https://doi.org/10.1002/ehf2.14926
Journal volume & issue
Vol. 11, no. 5
pp. 3290 – 3298

Abstract

Read online

Abstract Aims Parameters derived from reservoir‐excess pressure analysis have been demonstrated to predict cardiovascular events. Thus, altered reservoir‐excess pressure parameters could have a detrimental effect on highly‐perfused organs like the heart. We aimed to cross‐sectionally determine whether reservoir‐excess pressure parameters were associated with N‐terminal pro‐brain‐type natriuretic peptide (NT‐proBNP) in older adults. Methods We studied 868 older adults with diverse cardiovascular risk. Reservoir‐excess pressure parameters were obtained through radial artery tonometry including reservoir pressure integral, peak reservoir pressure, excess pressure integral (INTXSP), systolic rate constant (SRC) and diastolic rate constant (DRC). Plasma levels of NT‐proBNP, as a biomarker of cardiac overload, were analysed by the Proximity Extension Assay technology. Results Multivariable linear regression analyses revealed that all reservoir‐excess pressure parameters studied were associated with NT‐proBNP after adjusting for age and sex. After further adjustments for conventional cardiovascular risk factors, INTXSP [β = 0.191 (95% confidence interval, CI: 0.099, 0.283), P < 0.001], SRC [β = −0.080 (95% CI: −0.141, −0.019), P = 0.010] and DRC [β = 0.138 (95% CI: 0.073, 0.202), P < 0.001] remained associated with NT‐proBNP. Sensitivity analysis found that there were occasions where the association between SRC and NT‐proBNP was attenuated, but both INTXSP and DRC remained consistently associated with NT‐proBNP. Conclusions The observed associations between reservoir‐excess pressure parameters and NT‐proBNP suggest that altered reservoir‐excess pressure parameters may reflect an increased load inflicted on the left ventricular cardiomyocytes and could have a potential to be utilized in the clinical setting for cardiovascular risk stratification.

Keywords