N-Terminal Pro-B-Type Natriuretic Peptide Is Related to Retinal Microvascular Damage: The Rotterdam Study.
OBJECTIVE
N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a marker of cardiac dysfunction and has been linked to various indices of large vessel disease. However, it remains unclear whether NT-proBNP also relates to microvascular damage. In a community-dwelling population, we studied the association between NT-proBNP and retinal microvascular damage.


APPROACH AND RESULTS
From the population-based Rotterdam Study, we included 8437 participants (mean age 64.1 years and 59% women) without a history of cardiovascular disease, with NT-proBNP data and gradable retinal images. NT-proBNP serum levels were measured using an immunoassay. Retinopathy signs, that is, exudates, microaneurysms, cotton wool spots, and dot/blot hemorrhages, present on fundus photographs were graded in the total study population; retinal vascular calibers, that is, arteriolar and venular calibers, were semiautomatically measured in a subsample (n=2763) of the study population. We conducted cross-sectional analyses on the association between NT-proBNP and retinal microvascular damage using logistic and linear regression models, adjusting for age, sex, and cardiovascular risk factors. We found that NT-proBNP was associated with the presence of retinopathy (adjusted odds ratio [95% confidence interval] per SD increase in natural log-transformed NT-proBNP: 1.14 [1.03-1.27]). We also found that higher NT-proBNP was associated with narrower arteriolar calibers (adjusted mean difference in arteriolar caliber per SD increase in natural log-transformed NT-proBNP: -0.89 µm [-1.54 to -0.24]). This association remained unchanged after excluding participants with retinopathy signs.


CONCLUSIONS
In participants free of clinical cardiovascular disease, higher levels of NT-proBNP are associated with retinal microvascular damage, suggesting a potential role for NT-proBNP as marker for small vessel disease.
['Mutlu|Unal|U|', 'Ikram|M Arfan|MA|', 'Hofman|Albert|A|', 'de Jong|Paulus T V M|PT|', 'Klaver|Caroline C W|CC|', 'Ikram|M Kamran|MK|']
D000368:Aged D001160:Arterioles D015415:Biomarkers D003430:Cross-Sectional Studies D005260:Female D006801:Humans D007118:Immunoassay D016014:Linear Models D016015:Logistic Models D008297:Male D008875:Middle Aged D020097:Natriuretic Peptide, Brain D009426:Netherlands D016017:Odds Ratio D010446:Peptide Fragments D010781:Photography D011237:Predictive Value of Tests D012164:Retinal Diseases D018570:Risk Assessment D012307:Risk Factors D015854:Up-Regulation D014652:Vascular Diseases D014699:Venules
N-terminal pro-BNP arterioles biomarkers etiology heart diseases venules