NT pro BNP as a potential marker of left atrial dysfunction in rheumatic mitral stenosis and its correlation with improvement in left atrial functions post percutaneous balloon mitral volvotomy (PBMV) with intermediate term follow up of 1 year

Khare, Rashi; Dwivedi, Sudhanshu Kumar; Saran, Ram Kirti; Chandra, Sharad

doi:10.1016/j.ihj.2014.10.390

Cited by 4 publications

(5 citation statements)

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“…The researchers that explored the relationship between NT-ProBNP and left atrial dysfunction in rheumatic mitral stenosis and how it correlates with left atrial function after PBMV discovered a substantial rise in LA SEC in conjunction with a decrease in LAA EV, as did Khare and coworkers [15].…”

Section: Discussionmentioning

confidence: 93%

Spontaneous left atrial echo contrast, mitral annular systolic velocity, and left atrial appendage late emptying velocity in predicting improvement of left atrial function after percutaneous balloon mitral valvuloplasty

Abd-ELfattah

kabil²,

Hussein³

et al. 2022

Benha Journal of Applied Sciences

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LA/LAA dysfunction is a serious concern in patients with severe mitral stenosis, which may lead to blood stasis and thromboembolic consequences, as well as heart failure.In this research, we aimed to examine the impact of PBMV on LA/LAA function, specifically focusing on mitral annulus Sa velocity, SEC grade and LAA TDI parameters, in order to identify the determinants of improved LA/LAA function. Methods: Preliminary research was undertaken between June 2020 and April 2022 at a Tertiary Care Hospital in the United States. At the National Heart Institute's Cardiology Department, a total of 50 patients with symptomatic, isolated, severe mitral stenosis underwent PBMV surgery. Dyspnea was a common symptom in more than half of our patients, most of whom were in their 30s and 40s (NYHA class II). An improved LA/LAA SEC grade, decreased mitral valve diastolic pressure gradient and decreased diastolic left atrial diameter were all seen following PBMV. After PBMV, mitral annular Sa velocity, LAAEV, and LAAFV were all significantly improved. " We also found that improvement in LA/LAA function after PBMV was significantly predicted by mitral annular Sa velocity. The SEC grade of the LA/LAA was shown to be a major predictor of improvement in LA/LAA function following PBMV. Our findings showed that the mital annular Sa velocity cutoff value was 5.5 cm/s was the ideal speed for predicting an inactive LAA. The cutoff value for LAAEV in our investigation was 25 cm/sec for the prediction of inactive LA/LAA. Conclusion: Pre-PBMV inactivity was predicted by lower Sa-wave velocity; after PBMV inactivity was predicted by higher Sa-wave velocity, higher LAAEV, lower SEC grade, lower left atrial diameter, larger MVA and lower PASP. Specifically, lower left atrial diameter, larger MVA and lower PASP were associated with improved LA function after PBMV.

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Section: Discussionmentioning

confidence: 93%

Spontaneous left atrial echo contrast, mitral annular systolic velocity, and left atrial appendage late emptying velocity in predicting improvement of left atrial function after percutaneous balloon mitral valvuloplasty

Abd-ELfattah

kabil²,

Hussein³

et al. 2022

Benha Journal of Applied Sciences

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“…This finding was supported by a study by Sharma et al (2011) [ 56 ] in RHD mitral stenosis patients; it was found that both BNP and atrial natriuretic peptide (ANP) were associated with disease severity, but ANP was not shown to be significantly related to exercise capacity or increased blood pressure during exercise. In contrast, increased BNP was associated with a lower left atrial area index, lower exercise capacity, and higher pulmonary artery pressure [ 54 ]. A decrease in the value of NT-pro BNP in our study could indicate a decrease in myocardial stress, specifically in the left atrial myocardium [ 56 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, other studies have uncovered the possibility of different sites synthesizing or producing BNP. Research by Khare and Dwivedi (2016) found a correlation between left atrial dysfunction examined by tissue-Doppler-derived strain/strain rate (S/Sr) and NT-pro BNP levels [54]. This hormone level can also be used to predict improvement in left atrial function after percutaneous mitral balloon valvuloplasty.…”

Section: Discussionmentioning

confidence: 99%

Effect of Dapagliflozin on Patients with Rheumatic Heart Disease Mitral Stenosis

Asrial,

Reviono,

Soetrisno

et al. 2023

JCM

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(1) Background: Mitral stenosis is the most common rheumatic heart disease (RHD). Inflammation and fibrosis are the primary pathophysiology, resulting in left atrial stress and dysfunction. Dapagliflozin is a new heart failure treatment with anti-inflammation and anti-fibrosis effects from previous studies. However, the specific role of dapagliflozin in RHD mitral stenosis is unknown. This study aims to investigate (i) the effect of dapagliflozin on biomarkers of fibrosis, NT-pro BNP levels and left atrial function; (ii) the relationship between the changes in fibrosis biomarkers with left atrial function and NT-pro BNP levels. (2) Methods: An open-label randomized study was conducted on 33 RHD mitral stenosis patients divided into a dapagliflozin group which received 10 mg dapagliflozin and standard therapy, and a control group which only received standard therapy. All patients were examined for levels of PICP, MMP-1/TIMP-1 ratio, TGF-β1, NT-proBNP, mitral valve mean pressure gradient (MPG), and net atrioventricular compliance (Cn) pre- and post-intervention. (3) Results: This study found a significant increase in PICP and TGF-β1 and a reduction in the MMP-1/TIMP-1 ratio in the dapagliflozin group and the control group (p < 0.05). In the dapagliflozin group, the levels of NT-pro BNP decreased significantly (p = 0.000), with a delta of decreased NT-pro BNP levels also significantly greater in the dapagliflozin group compared to the control (p = 0.034). There was a significant increase in Cn values in the dapagliflozin group (p = 0.017), whereas there was a decrease in the control group (p = 0.379). Delta of changes in Cn values between the dapagliflozin and control groups also showed a significant value (p = 0.049). The decreased MPG values of the mitral valve were found in both the dapagliflozin and control groups, with the decrease in MPG significantly greater in the dapagliflozin group (p = 0.031). There was no significant correlation between changes in the value of fibrosis biomarkers with Cn and NT-pro BNP (p > 0.05). (4) Conclusions: This study implies that the addition of dapagliflozin to standard therapy for RHD mitral stenosis patients provides benefits, as evidenced by an increase in net atrioventricular compliance and decreases in the MPG value of the mitral valve and NT-pro BNP levels (p < 0.05). This improvement was not directly related to changes in fibrosis biomarkers, as these biomarkers showed ongoing fibrosis even with dapagliflozin administration.

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“…This is a fact of particular importance since it reaffirms the idea that intensive surveillance is necessary during the first days and probably a hospital admission is recommended in those patients with high levels of this marker. We now know that higher values of NT-pro-BNP and its derivates are associated with an increased risk of ischemic stroke [19][20][21], because they reflect a greater risk of atrial fibrillation [27], and a higher severity of atrial disease [28][29][30] and other potentially embolic cardiopathies [31][32][33]. Therefore, it is to be expected that if the risk is greater the likelihood that the embolic event occurs earlier is also greater.…”

Section: Discussionmentioning

confidence: 99%

NT-pro-BNP: A novel predictor of stroke risk after transient ischemic attack

Rodríguez‐Castro

Hervella²,

López‐Dequidt

et al. 2020

International Journal of Cardiology

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NT pro BNP as a potential marker of left atrial dysfunction in rheumatic mitral stenosis and its correlation with improvement in left atrial functions post percutaneous balloon mitral volvotomy (PBMV) with intermediate term follow up of 1 year

Cited by 4 publications

References 0 publications

Spontaneous left atrial echo contrast, mitral annular systolic velocity, and left atrial appendage late emptying velocity in predicting improvement of left atrial function after percutaneous balloon mitral valvuloplasty

Spontaneous left atrial echo contrast, mitral annular systolic velocity, and left atrial appendage late emptying velocity in predicting improvement of left atrial function after percutaneous balloon mitral valvuloplasty

Effect of Dapagliflozin on Patients with Rheumatic Heart Disease Mitral Stenosis

NT-pro-BNP: A novel predictor of stroke risk after transient ischemic attack

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