B-type natriuretic peptide efficacy compared to fragmented QRS for diastolic dysfunction screening in patients with type 2 diabetes

doi:10.4239/wjd.v16.i4.103551

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World Journal of Diabetes

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1948-9358

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Cohort Study

World J Diabetes. Apr 15, 2025; 16(4): 103551
Published online Apr 15, 2025. doi: 10.4239/wjd.v16.i4.103551

B-type natriuretic peptide efficacy compared to fragmented QRS for diastolic dysfunction screening in patients with type 2 diabetes

Kunimasa Yagi, Daisuke Chujo, Isao Usui, Jian-Hui Liu, Atsushi Nohara, Asako Enkaku Shirozu, Akiko Takikawa, Hisae Honoki, Shiho Fujisaka, Hideki Origasa, Hayato Tada

Kunimasa Yagi, Department of Internal Medicine, Kanazawa Medical University Hospital, Kahoku 920-0293, Ishikawa, Japan

Daisuke Chujo, Center for Clinical and Translational Research, Toyama University Hospital, Toyama 930-0152, Toyama, Japan

Isao Usui, Department of Endocrinology and Metabolism, Dokkyo Medical University, Utsunomiya 321-0293, Tochigi, Japan

Jian-Hui Liu, Department of Cardiology, Ningbo Medical Center of Lihuili Hospital, Ningbo 315041, Zhejiang Province, China

Atsushi Nohara, Department of Clinical Genetics, Ishikawa Prefectural Central Hospital, Kanazawa 920-8530, Ishikawa, Japan

Asako Enkaku Shirozu, Akiko Takikawa, Hisae Honoki, Shiho Fujisaka, The First Department of Internal Medicine, Toyama University Hospital, Toyama 930-0152, Toyama, Japan

Hideki Origasa, Data Science and AI Innovation Research Promotion Center, Institute of Statistical Mathematics, Shiga University, Hikone 525-0034, Shiga, Japan

Hayato Tada, Division of Cardiovascular Medicine, Kanazawa University, Graduate School of Medicine, Kanazawa 920-8640, Ishikawa, Japan

Author contributions: Yagi K acquired funding; Yagi K, Usui I, and Nohara A contributed to the design of the study; Chujo D, Liu JH, Shirozu AE, Takikawa A, Honoki H, and Fujisaka S contributed to the data curation; Yagi K, Origasa H, and Tada H participated in the statistical analysis; Yagi K wrote the original draft; Chujo D, Usui I, Liu JH, Nohara A, Origasa H, and Tada H participated in the review and editing; All the authors approved the final draft of the manuscript.

Supported by the JSPS KAKENHI, No. JP21K10300 and No. JP24K02714.

Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of the Ethics Committee of Toyama University Hospital (No. R2020141).

Informed consent statement: All participants provided informed consent and web-based notifications were used to inform them of their right to opt out at any time.

Conflict-of-interest statement: The authors declare that they have no conflict of interest.

STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.

Data sharing statement: Data supporting the findings of this study are available from the corresponding author upon reasonable request.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Kunimasa Yagi, MD, PhD, Professor, Department of Internal Medicine, Kanazawa Medical University Hospital, 1-1 Daigaku, Uchinada, Kahoku 920-0293, Ishikawa, Japan. yagikuni@icloud.com

Received: November 25, 2024
Revised: January 4, 2025
Accepted: January 21, 2025
Published online: April 15, 2025
Processing time: 98 Days and 3.7 Hours

Core Tip

Core Tip: Early diagnosis of left ventricular diastolic dysfunction (LVDD) is critical for preventing heart failure in patients with type 2 diabetes. The effectiveness of B-type natriuretic peptide (BNP) measurement for diagnosing LVDD in patients with type 2 diabetes remains controversial. BNP levels may underestimate the severity of LVDD because of their lower values in individuals with high body mass index or insulin resistance. A fragmented QRS (fQRS) on electrocardiography mainly reflects myocardial fibrosis and has been reported to reflect diastolic dysfunction in individuals with type 2 diabetes. Here, we compared the diagnostic efficacy of BNP and fQRS for LVDD, highlighting the utility of fQRS evaluation.