Determinants of Invasively Measured Aortic Pulse Pressure andits Relationship with B-type Natriuretic Peptides in StablePatients with Preserved Left Ventricular Systolic Function

Wide aortic pulse pressure (PP) and levels of natriuretic peptides were repeatedly demonstrated as predictors of cardiovascular morbidity and mortality even in a population without a history of heart disease. The aim of the work was to find determinants of invasively measured aortic pulse pressure and B-type natriuretic peptide (BNP), and a relationship of both markers in stable patients undergoing diagnostic coronary angiography with preserved left ventricle systolic function. Population and methods: A total of 386 stable patients with left ventricle ejection fraction > 50%, without acute myocardial infarction, aortic or mitral valve disease were enrolled. Invasive intra-aortic blood pressure was measured using a fluid-filled catheter in the ascending aorta. Samples of venous blood for analysis of the BNP level were drawn before coronary angiography. Results: We found a positive correlation between aortic systolic blood pressure (SBP) and PP (Pearson’s correlation coefficient = 0.44, p<0.001). Positive relationships were determined among aortic PP and gender, age, BNP, glycaemia, high-density lipoprotein (HDL) cholesterol, hypertension and diabetes mellitus. Negative relationships were found among aortic PP and height, weight and ischemic heart disease, but only gender and age were detected as independent factors in multivariate model. Positive correlation of BNP with age, aortic PP, Left ventricular end diastolic pressure (LVEDP), hypertension, smoking and a negative correlation with creatinine, total cholesterol and ischemic heart disease were shown; only age, creatinine, cholesterol and non- smoker status were independent predictors of BNP value in multivariate model. Conclusion: We found independent determinants of two important predictive markers of cardio-vascular morbidity and mortality – BNP and PP - in group of stable patients.