| Background:Diabetes is a syndrome with chronic high blood glucose as the main features. Cardiovascular diseases are main complication of diabetes and main cause of its death. The pathological changes of heart disease in diabetes included coronary heart disease and cardiomyopathy lesions. This could lead to cardiac failure. Cardia failue develops gradully, the pathology and physiological changes of which is begun with LVD. In the early stages of LVD, ejection fraction of heart is normal.In this stage, nowadays diagnosis methods are difficult. It would be benefit to control the progression of LVD, to improve cardia compensatory mechanism, if it be diagnosis and reasonable treatment on time. So early identificating the type 2 diabetes patients with cardiac diastolic dysfunction is clinically important.BNP is a peptide mainly secreted from the ventricles. When ventricular wall tension is overload or increasing, its secretion increases. BNP can reflect cardia insufficiency. Some researches show that the diagnosis of LVD is important. But there are just a few reports for the diagnosis of cardiac function in patients with diabetes. In this study, the concentration of BNP was detected in type 2 diabetes patients with LVD, to see if it is helpful in the diagnos of these patients.Objective: Serum B-type natriuretic peptide (BNP) level was detected in type 2 diabetes patients with LVD, to explore its value in diagnose this disease.Methods: Out-patient and hospital patients in Xijing Hospital from January 2008 to January 2009 were randomly choosed as research subjects. 80 cases of type 2 diabetes mellitus with left ventricular dysfunction grouped as T2DM + LVD patients, 40 type 2 diabetes mellitus with no heart changes grouped as T2DM patients, while 30 cases of normal persons and 32 cases of patients with non-diabetic left ventricular dysfunction grouped as control and LVD patients respectively. Left ventricular ejection fraction was measured with echocardiography, while serum BNP concentration was determinated by enzyme-linked immunosorbent assay.Results: BNP levels in T2DM + LVD patients (221.1±54.1 pg /ml) higher than in other 3 group patients (P<0.01), serum BNP levels in LVD (140.1±27.4 pg/ml) was higher than that in T2DM patients (82.4±29.4 pg/ml) and normal control (60.9±25.7pg/ml), with statistical significance (P< 0.05); BNP level in T2DM patients and normal control group had no difference. Receiver operating characteristic curve analysis showed that BNP cutoff point at 90pg/ml for diagnosis of LVD having sensitivity as 87%, specificity as 92% and accuracy rate as 88%. In The serum BNP levels positively correlated with age (r= 0.3326, P <0.05); and with fasting blood glucose (r = 0.2754, P <0.05). HbA1c and serum BNP level had no correlation (r = 0.2028, P = 0.0853).Conclusion: Left ventricular dysfunction patients had high serum BNP levels, while diabetic patients with left ventricular dysfunction had higher levels, suggesting that determination of serum BNP concentration can be an objective assessment of cardiac function, it is helpful to identify asymptomatic patients with left ventricular dysfunction in early stage. Detection of serum BNP is a simple, cheap and reliable screening indicator in diabetes patients with left ventricular dysfunction.
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