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Relation of N-terminal pro-B-type natriuretic peptide to symptoms, severity, and left ventricular remodeling in patients with organic mitral regurgitation

Potocki, Mihael and Mair, Johannes and Weber, Michael and Hamm, Christian and Burkard, Thilo and Hiemetzberger, Renate and Peters, Klaus and Jander, Nikolaus and Cron, Thomas A. and Hess, Niklaus and Hoffmann, Andreas and Gekeler, Helmut and Gohlke-Bärwolf, Christa and Buser, Peter and Mueller, Christian. (2009) Relation of N-terminal pro-B-type natriuretic peptide to symptoms, severity, and left ventricular remodeling in patients with organic mitral regurgitation. The American journal of cardiology : official journal of the American College of Cardiology, Vol. 104. pp. 559-564.

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Official URL: http://edoc.unibas.ch/dok/A6005649

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Abstract

Natriuretic peptides reflect cardiac stress and may therefore be useful in the management of patients with valvular heart disease. Data regarding these biomarkers in organic mitral regurgitation (MR) are sparse. In this study, 144 patients with moderate or severe organic MR were prospectively enrolled in an observational, multicenter study to analyze the relation of N-terminal-pro-B-type natriuretic peptide (NT-pro-BNP) to symptoms, severity of MR, and echocardiographic parameters. NT-pro-BNP levels (median 373 pg/ml, interquartile range 150 to 997) were associated with age, gender, creatinine, New York Heart Association (NYHA) functional class, atrial fibrillation, left ventricular (LV) end-systolic dimension, and the LV ejection fraction. Independent predictors of increased NT-pro-BNP levels were NYHA functional class (p = 0.003), atrial fibrillation (p = 0.005) and LV end-systolic dimension (p = 0.029). MR severity and left atrial dimension were not independently associated with NT-pro-BNP levels. NT-pro-BNP levels increased significantly with NYHA class (p >0.001) but not with MR severity (p = 0.144). NT-pro-BNP levels were significantly higher in symptomatic patients than in asymptomatic patients (582 pg/ml [interquartile range 246-1,360] vs 157 pg/ml [interquartile range 64 to 256], p >0.0001). The area under the receiver-operating characteristic curve to predict symptoms for NT-pro-BNP was 0.80 (95% confidence interval 0.71 to 0.88), which was significantly higher than for all echocardiographic variables (p >0.001 for all). In conclusion, NYHA functional class, atrial fibrillation, and LV end-systolic dimension are independent predictors of increased NT-pro-BNP levels in patients with moderate or severe organic MR. Therefore, NT-pro-BNP may be helpful in the clinical evaluation and management of patients with MR, especially when it is doubtful whether symptoms are related to MR or not.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Ehemalige Einheiten Medizinische Fächer (Klinik) > Stationäre innere Medizin (Schifferli)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Ehemalige Einheiten Medizinische Fächer (Klinik) > Stationäre innere Medizin (Schifferli)
03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Kardiologie
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Kardiologie
03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Kardiologie > Kardiologie (Buser)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Kardiologie > Kardiologie (Buser)
UniBasel Contributors:Hoffmann, Andreas and Buser, Peter and Müller, Christian
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Elsevier Science
ISSN:0002-9149
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:01 Mar 2013 11:13
Deposited On:01 Mar 2013 11:09

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