Objectives Recently, the prognostic role of N-terminal pro-brain natriuretic peptide (NT-pro BNP) in heart failure and coronary diseases has been demonstrated in many studies. SYNTAX score was pioneered as an anatomical-based risk score that aided in this decision-making process in appropriately informing patients electing to undergo coronary artery bypass graft (CABG) surgery or percutaneous coronary intervention (PCI). However is not known if there is a relation between NT-pro BNP levels and SYNTAX score (SS). A present study came to investigate the relationship between plasma NT-pro BNP level and extent and complexity of coronary lesions assessed using SS in patients with stable angina pectoris candidate for coronary angiography. Methods The study population included 203 consecutive patients with stable angina and intend for selective coronary angiography. SS was calculated in all participants, According to SS value,all subjects were divided into three groups: low risk (< 22), intermediate risk (23-32), and high risk (≥ 33).blood samples were drawn from femoral or radial artery for NT-pro BNP measurement just before the catheterisation of left coronary. Results Regarding the role of N terminal pro BNP for assessing severity of coronary lesions based on SS, The NT pro BNP level increased significantly as risk classification of SS upgraded (P < 0.05). Linear regression analysis showed that plasma NT-pro BNP level was significantly associated with SS (r = 0.314, P < 0.01). Conclusions NT-pro BNP can be a good parameter for predicting severity of coronary lesions. NT-pro BNP level was significantly associated with the extent and complexity of coronary artery disease.
Background Prosthesis-patient mismatch (PPM) is associated with poor outcomes after surgical aortic valve replacement, but evidence in the era of transcatheter aortic valve replacement (TAVR) is small. Although PPM is conventionally defined by transthoracic echocardiogram (TTE) derived indexed effective orifice area (EOAi), TTE may underestimate left ventricular outflow tract (LVOT) area when compared with cardiac computed tomography angiography (CTA). Purpose To evaluate the inter-modality (TTE vs CTA) agreement and inter-valve (balloon-expanding valve (BEV) vs. self-expandable valve (SEV)) differences in EOAi and the severity of PPM after TAVR. Methods We analyzed all patients who underwent TAVR between 2015 to 2017and who had both of CTA and TTE at 30-days after TAVR. EOAi was calculated using the continuity equation and then indexed to body surface area as per guidelines using TTE derived LVOT diameter (EOAi-TTE) or post-procedure CTA derived LVOT area (EOAi-CTA). The external LVOT diameter was measured at inflow of TAVR bioprosthetic stent frame as per recommendations. The EOAi was used to define the grading severity of PPM: None (> 0.85 cm²/m²); Moderate (0.65 to 0.85 cm²/m²); and Severe (< 0.65 cm²/m²). Paired or Student t-test and Chi-square test were used to assess the inter-modality and inter-valve difference. Results A total of 280 patients were included (the mean age, 81.2 ± 8.1 years; 48%, female). BEV was used in 150 patients (54%). The mean EOAi-TTE vs. EOAi-CTA was 1.00 ± 0.32 and 1.41 ± 0.50 cm²/m², respectively, p < 0.001. Prevalence of severe (TTE 9% versus CTA 4%, p < 0.01) and moderate (TTE 28% versus CTA 7%, p < 0.01) PPM was lower when adjudicated by CTA (Figure-Panel A). There was a trends towards smaller EOAi by either TTE (0.97 ± 0.31 vs. 1.04 ± 0.33, p = 0.07) or CTA (1.38 ± 0.45 vs. 1.46 ± 0.56, p = 0.21) for BEV vs. SEV (Figure-Panel B). There was no significant difference in the severity of PPM defined by either EOAi-TTE (Figure-Panel C) or EOAi-CTA (Figure-Panel D) between these patients. Conclusion EOAi-CTA was larger and downgraded the severity of PPM than the EOAi-TTE. There was no significant difference in the severity of PPM defined by post-procedure CT between patients treated with BEV and those with SEV. Abstract P212 Figure.
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