Correlation of the myocardial performance index with BNP in patients with type II Diabetes Mellitus and impaired glucose tolerance

Background and Objectives: Diabetes Mellitus(DM) and impaired glucose tolerance are releated left ventricular dysfunction.In this study we aimed to look for, if myocardial performance index(MPI) measured by tissue doppler and brain natriuretic peptide(BNP) can show myocardial functional abnormality and to test if they are interrelated to each other.Methods: The patients excluded in the study were having the diagnosis of hypertension, coronary artery disease and use of antihypertensive agent. We established a control group which had the same exclusion criterias. Basal clinical findings, routine labaratory findings and BNP levels of patients were recorded. In all patients, MPIs which were measured by both conventional method and also by tissue dopper and E wave deceleration time(EDT), E/A, E/E? parameters were recorded. Differences between groups were also tested between all patients and also between subgroups of patients with DM and IGT.Results: 31 type II DM patients and 21 patients with IGT were included in the study.As a control group we established 30 persons of healty volunteers.Male sex ratio, body mass index, Hb,BUN,Creatinine, LDL, HDL, end-systolic and end-diastolic measures of left ventricle were similar in each three groups. The BNP values of the DM group were greater than IGT and the control group and the BNP values of IGT were also greater compared to the control group (36 ±17 vs. 61±20 and 75±17, p<0.001). MPI values measuered by the conventional method were significantly different between groups, highest in the DM group and lowest in the control group(0,41 ± 0,05, 0,53 ± 0,1, 0,62 ± 0,06, p< 0,001 ). The findings with tissue Doppler were similar and were significantly different between groups ( 0,51 ± 0,05, 0,57 ± 0,11, 0,63 ± 0,07, p< 0,001 ). We performed correlation test in a group composed of DM and IGT patients in order to look if there is a relation between BNP and MPI and also with other parameters. We found a significant positive correlation between BNP and mean MPI values(r value: 0,574, p< 0,001).Both BNP and mean MPI were having a significant relationship with EDT, E/E? and MPI measured by the conventional method. The positive correlation between BNP and mean MPI values still held in a subgroup of patients which were all type II DM patients( r value : 0,499, p = 0,04 ). The same correlation continued to be true in the patient group with IGT (r value: 0,543, p = 0, 01). The EDT, E/E? and MPI values measured by the conventional method kept their significant relationship between these subgroups.Conclusion: BNP and MPI which are two important prognostic parameters can be used in DM and IGT patients to define risky groups. We think that in patients where enough discrimination cannot be provided by either BNP or MPI, the relationship between these parameters can be used to define the risk of the patient.