Judgment about myocardial function with plasma BNP in patients with noninsulin-dependent diabetes mellitus

Objective:To study the alteration of cardiac function in diabetic patients and evaluate the relationship between cardiac function and BNP. Methods:83 diabetic patients and 12 healthy subjects were selected into the study. Left ventricular ejection fraction(LVEF) and mitral annular early diastole (E) and late diastole (A) inflow velocities were measured with echocardiography. Plasma BNP were measured with Immnoradiometic assay(IRMA)? Results:According to the result of the echocardiography, the diabetics who have no primary cardiac diseases were subdivided into normal cardiac function group( n =24,28.9%),diastolic dysfunction group( n =47,56.7%), systolic dysfunction group( n =6,7.2%), both diastolic and systolic dysfunction group( n =6,7.2%). More than half of diabetic patients have diastolic dysfunction. The plasma level of BNP had significant negative correlation with LVEF( r = -0.614, P 0.01).In the diastolic cardiac dysfunction group, the plasma BNP increased with diastolic heart failure severity, and the BNP had significant negative correlation with E/A( r =-0.535, P 0.01). A plasma BNP concentration exceeding 48 ng/L had a sensitivity of 91.7% and a specificity of 83.3% for detection of systolic cardiac dysfunction with diabetics. A plasma BNP concentration exceeding 11 ng/L had a sensitivity of 93.6% and a specificity of 85.2% for detection of diastolic cardiac dysfunction with diabetics. Conclusion:The plasma levels of BNP increase significantly according to the severity of diastolic and systolic cardiac dysfunction. The plasma BNP concentration may be a good biochemical parameter for evaluating the cardiac function of diabetic patients.