B‐type natriuretic peptide is associated with remodeling and exercise capacity after transcatheter aortic valve replacement for aortic stenosis

Sato, Kimi; Kumar, Arnav; Krishnaswamy, Amar; Mick, Stephanie; Desai, Milind Y.; Griffin, Brian P.; Kapadia, Samir; Popović, Zoran B.

doi:10.1002/clc.23138

Cited by 13 publications

(10 citation statements)

References 31 publications

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“…The BNP population had a mean age of 61 years and 42% were male, whereas the mean age of participants in the NT-proBNP population was higher at 78 years and 57% were male. All-cause mortality was reported in 21 of the BNP studies [6][7][8][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] and the remaining studies reported major adverse cardiovascular events (MACE) [34][35][36][37][38]. The vast majority found that BNP had a significant association with all-cause mortality, with an average threefold increase in death on increasing levels of BNP.…”

Section: Natriuretic Peptidesmentioning

confidence: 99%

Biomarkers Associated with Mortality in Aortic Stenosis: A Systematic Review and Meta-Analysis

et al. 2021

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The optimal timing of aortic valve replacement (AVR) remains controversial. Several biomarkers reflect the underlying pathophysiological processes in aortic stenosis (AS) and may be of use as mortality predictors. The aim of this systematic review and meta-analysis is to evaluate the blood biomarkers utilised in AS and assess whether they associate with mortality. PubMed and Embase were searched for studies reporting baseline biomarker level and mortality outcomes in patients with AS. A total of 83 studies met the inclusion criteria and were systematically reviewed. Of these, 21 reporting brain natriuretic peptide (BNP), N-terminal pro B-type natriuretic peptide (NT-proBNP), Troponin and Galectin-3 were meta-analysed. Pooled analysis demonstrated that all-cause mortality was significantly associated with elevated baseline levels of BNP (HR 2.59; 95% CI 1.95–3.44; p < 0.00001), NT-proBNP (HR 1.73; 95% CI 1.45–2.06; p = 0.00001), Troponin (HR 1.65; 95% CI 1.31–2.07; p < 0.0001) and Galectin-3 (HR 1.82; 95% CI 1.27–2.61; p < 0.001) compared to lower baseline biomarker levels. Elevated levels of baseline BNP, NT-proBNP, Troponin and Galectin-3 were associated with increased all-cause mortality in a population of patients with AS. Therefore, a change in biomarker level could be considered to refine optimal timing of intervention. The results of this meta-analysis highlight the importance of biomarkers in risk stratification of AS, regardless of symptom status.

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Section: Natriuretic Peptidesmentioning

confidence: 99%

Biomarkers Associated with Mortality in Aortic Stenosis: A Systematic Review and Meta-Analysis

et al. 2021

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“…Interestingly, in our study, the post-TAVR serum BNP was significantly associated with residual PVL and MR as well as with higher PHT and lower EF, all of which were previously implicated to be associated with elevated BNP serum levels and worse prognosis [56-58]. It seems that post-procedural serum BNP may incorporate several post-TAVR residual hemodynamic known prognostic post-TAVR parameters [24, 48, 59, 60], each by itself reflecting the combined hemodynamic prognostic profile, and all of which elevated post-TAVR serum BNP levels.…”

Section: Discussionmentioning

confidence: 70%

“…BNP is noted for its short 20-min half-life time [15, 47]. While serum BNP levels were evaluated for short-term outcomes [30-32, 46, 48] and long-term outcomes [34, 49] following TAVR, the majority of these studies were based on pre-procedural admission BNP levels [30-32, 34, 46, 48, 49]. There are limited data evaluating BNP levels post-TAVR at both post-TAVR prior to discharge [33] as well as at 30-day post-TAVR [34, 49].…”

Section: Discussionmentioning

confidence: 99%

Pre- and Post-Transcatheter Aortic Valve Replacement Serum Brain Natriuretic Peptide Levels and All-Cause Mortality

et al. 2020

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Background: Risk stratification in patients post-transcatheter aortic valve replacement (TAVR) is limited to and is based on clinical judgment and surgical scoring systems. Serum natriuretic peptides are used for general risk stratification in patients with aortic stenosis, reflecting the increase in their afterload and thereby stressing the need for valve intervention. The objective of this study was to determine the predictive value of pre- and post-procedural serum brain natriuretic peptide (BNP) on 1-year all-cause mortality in patients who underwent TAVR. Methods: In this population-based study, we included 148 TAVR patients treated at the Poriya Medical Center between June 1, 2015, and May 31, 2018. Routine blood samples for serum BNP levels (pg/mL) were taken just before the TAVR and 24 h post-TAVR. Our primary clinical outcome was defined as 1-year all-cause mortality. We used backward regression models and included all variables that had a p value <0.1 in the univariable analysis. A receiver-operating characteristic curve was calculated for the prediction of all-cause mortality by serum BNP levels using the median as the cut-off point. Results: In this study cohort, BNP levels 24 h post-TAVR higher than the cohort median versus lower than the cohort median (387.5 pg/mL; IQR 195–817.6) were the strongest predictor of 1-year mortality (hazard ratio 9; 95% CI 2.72–30.16; p < 0.001). The statistically significant relationship was seen in the unadjusted regression model as well as after the adjustment for clinical variables. Conclusions: Serum BNP levels 24 h post-procedure were found to be a meaningful marker in predicting 1-year all-cause mortality in patients after TAVR procedure.

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“…As the indication of TAVR extended, increasing studies were performed to find the predictor of long-term prognosis. However, limited biomarkers were proposed as a predicting long-term outcome [ 2 , 3 , 26 ]. In the present study, we found altered metabolites responding to TAVR in the peripheral vein in 1 day, 3 days, and 7 days after TAVR could reflect LVM regression.…”

Section: Discussionmentioning

confidence: 99%

Metabolic Modulation and Potential Biomarkers of the Prognosis Identification for Severe Aortic Stenosis after TAVR by a Metabolomics Study

Liao

Liu

Xiong

et al. 2020

Cardiology Research and Practice

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Objectives. To investigate the metabolic profile in patients with aortic stenosis (AS) after transcatheter aortic valve replacement (TAVR) and explore the potential biomarkers to predict prognosis after TAVR based on metabolomics. Methods and Results. Fifty-nine consecutive AS patients were prospectively recruited. Blood samples from the ascending aorta, coronary sinus, and peripheral vein at before and after TAVR were collected, respectively. Liquid chromatography-mass spectrometry and gas chromatography-mass spectrometry were performed to analyze the metabolic profile before and after TAVR. Influential metabolites were identified by integrating the univariate test, multivariate analysis, and weighted gene coexpression network analysis (WGCNA) algorithm. PLS-DA analysis revealed a significant extremely early (within 30 minutes after TAVR) alterations of metabolites in the ascending aorta, coronary sinus, and peripheral vein. The early (within 7 days after TAVR) changed metabolites in the peripheral vein were involved in purine metabolism, primary bile acid biosynthesis, glycerolipid metabolism, amino sugar and nucleotide sugar metabolism, one carbon pool by folate and alanine, and the aspartate and glutamate metabolism pathway. We used volcano plots to find that the cardiac-specific changed metabolites were enriched to the sphingolipid metabolism pathway after TAVR. Besides, WGCNA algorithm was performed to reveal that arginine and proline metabolites could reflect left ventricle regression to some extent. Conclusion. This is the first study to reveal systemic and cardiac metabolites changed significantly in patients with AS after TAVR. Some altered metabolites involved in the arginine and proline metabolism pathway in the peripheral vein could predict left ventricle regression, which merited further study.

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B‐type natriuretic peptide is associated with remodeling and exercise capacity after transcatheter aortic valve replacement for aortic stenosis

Cited by 13 publications

References 31 publications

Biomarkers Associated with Mortality in Aortic Stenosis: A Systematic Review and Meta-Analysis

Biomarkers Associated with Mortality in Aortic Stenosis: A Systematic Review and Meta-Analysis

Pre- and Post-Transcatheter Aortic Valve Replacement Serum Brain Natriuretic Peptide Levels and All-Cause Mortality

Metabolic Modulation and Potential Biomarkers of the Prognosis Identification for Severe Aortic Stenosis after TAVR by a Metabolomics Study

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