Serum N‐Terminal pro‐BNP Levels Correlate with Symptoms and Echocardiographic Findings in Patients with Mitral Stenosis

Arat-Özkan, Alev; Kaya, Ayşem; Yiğit, Zerrin; Balcı, Huriye; Ökçün, Barış; Yazicioğlu, Nuran; Küçükoǧlu, F.E.S.C. Serdar

doi:10.1111/j.1540-8175.2005.04085.x

Cited by 47 publications

(46 citation statements)

References 30 publications

(33 reference statements)

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“…In fact, the measurement of NT-pro-BNP can be used for assessing mitral stenosis severity as well. Similar to our study, Arat-Ozkan et al [11] could show that patients with mitral stenosis had higher NT-pro-BNP levels compared to controls, but they also found a significant correlation between NT-pro-BNP and left atrial and right ventricular size as well as mitral valve area, mean mitral gradient, peak PAP and NYHA functional class. Interestingly, similar to our observation, they showed that those with atrial fibrillation had significantly higher NT-pro-BNP levels compared to those with sinus rhythm.…”

Section: Discussionsupporting

confidence: 77%

The change in NT-pro-BNP and post-PTMC echocardiography parameters in patients with mitral stenosis. A pilot study

Safi

Bayat

Ahmadi

et al. 2017

Romanian Journal of Internal Medicine

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Background. The change in the level of NT-pro-BNP (N-terminal-pro-Brain Natriuretic Peptide) is now considered as a reflection of the hemodynamic alterations and its circulatory reductions reported early after successful PTMC (percutaneous transvenous mitral commissurotomy). The present study aims to assess the change in the level of NT-pro BNP following PTMC in patients with mitral stenosis and also to determine the association between circulatory NT-pro-BNP reduction and post-PTMC echocardiography parameters. Methods. Twenty five symptomatic consecutive patients with severe MS undergoing elective PTMC were prospectively enrolled. All patients underwent echocardiography before and also 24 to 48 hours after PTMC. Peripheral blood samples were taken for measurement of NT-pro-BNP before as well as 24 to 48 hours after PTMC. The patients were also classified in group with normal sinus rhythm or having atrial fibrillation (AF) based on their 12-lead electrocardiogram. Results. It was shown a significant decrease in the parameters of PPG (Peak Pressure Gradient), MPG (Mean Pressure Gradient), PHT (Pressure Half Time), PAP (Pulmonary Arterial Pressure), LAV (Left Atrial Volume), and also a significant increase in MVA (Mitral Valve Area) RVS (Right Ventricular S velocity), and strains of lateral, septal, inferior and anterior walls of LA following PTMC. The mean LVEF remained unchanged after PTMC. The mean NT-pro-BNP before PTMC was 309.20 ± 17.97 pg/lit that significantly diminished after PTMC to 235.72 ± 22.46 pg/lit (p = 0.009). Among all echocardiography parameters, only MPG was positively associated with the change in NT-pro-BNP after PTMC. Comparing the change in echocardiography indices between the patients with normal rhythm and those with AF, lower change in PAP was shown in the group with AF. However, more change in the level of NT-pro-BNP after PTMC was shown in the patients with AF compared to those without this arrhythmia. Conclusion. PTMC procedure leads to reduce the level of NT-pro-BNP. The change in NT-pro-BNP is an indicator for change in MS severity indicated by decreasing MPG parameter. Lower change in PAP as well as higher change in NT-pro-BNP is predicted following PTMC in the group with AF compared to those with normal sinus rhythm.

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Section: Discussionsupporting

confidence: 77%

The change in NT-pro-BNP and post-PTMC echocardiography parameters in patients with mitral stenosis. A pilot study

Safi

Bayat

Ahmadi

et al. 2017

Romanian Journal of Internal Medicine

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“…Accordingly, they claimed that NT-proBNP may be a valuable marker in monitoring disease progression. 22) In the literature, although ventricular myocardium was thought to constitute the major source of BNP, 23,24) some studies raised the possibility of the presence of different synthesis or secretion sites of BNP, other than the left ventricle, that contribute to the elevated plasma levels. 25,26) Two previous reports demonstrated an association between elevated BNP levels and left atrial dimension, indicating BNP synthesis in atrial myocytes in response to an increase in left atrial pressure.…”

Section: Discussionmentioning

confidence: 99%

“…The patient and control groups did not differ in terms of age (P = 0.722) [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] mm) dimensions were significantly higher in patients with MS (all P < 0.001). No significant difference was detected between the groups regarding left ventricular end-diastolic diameter (P = 0.795), left ventricular end-systolic diameter (P = 0.110), and ejection fraction (P = 0.156).…”

Section: Preprocedural Clinical and Morphologic Variables And Plasma mentioning

confidence: 99%

The Effect of Percutaneous Balloon Mitral Valvuloplasty on N-Terminal- Pro B- Type Natriuretic Peptide Plasma Levels in Mitral Stenosis

Selçuk

Maden

et al. 2007

Int. Heart J.

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SUMMARYThe objectives of this study were to assess the effect of percutaneous mitral balloon valvuloplasty (PBMV) on the plasma levels of N-terminal-pro B-type natriuretic peptide (NT-proBNP) in patients with mitral stenosis (MS) and to investigate the relationship between the changes in hemodynamic variables and NT-proBNP levels after PBMV. Plasma NT-proBNP concentrations were obtained from 60 symptomatic patients with rheumatic MS who underwent PBMV, and in 35 age-and gender-matched healthy volunteers. Patients with MS were found to have significantly higher levels of plasma NTproBNP compared to the control group (293 [77-1093] pg/mL versus 24 [12-67] pg/mL, respectively; [P < 0.001]). The mean preprocedural NT-proBNP level fell significantly from 293 (77-1093) pg/mL to 214 (69-1028) pg/mL (P < 0.001) following PBMV. The percentage decrease in plasma NT-proBNP levels was correlated only with the percentage decrease in systolic pulmonary artery pressure (r = 0.687, P < 0.001) and this correlation persisted in linear regression analysis (β = -0.013; 95% CI [-0.018--0.008] and P < 0.001). However, NT-proBNP levels did not correlate with the percentage of improvement in NYHA functional class, mitral valve gradients, or left atrial pressure (all P > 0.05). These findings indicate that NT-proBNP measurement following PBMV may be valuable for evaluating changes in pulmonary artery pressure and that elevated NTproBNP levels in patients with MS may reflect the increased wall stress in the left atrium and right side of the heart. (Int Heart J 2007; 48: 579-590) Key words: Mitral balloon, NT-proBNP, Pulmonary hypertension BRAIN natriuretic peptide (BNP) is a member of the natriuretic peptide family that has regulatory and modulatory roles in the cardiovascular system 1) including natriuresis, diuresis, and vasodilatation.

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“…Many of these patients are in atrial fi brillation (AF), which is known to be associated with increased levels. In one study, levels in patients with MS and AF were nearly twice as high as when patients were in sinus rhythm, (22) whereas there was no difference between patients with MS in sinus rhythm and AF in the study by Shang et al (24) In the latter study BNP levels remained unchanged 24 hours after mitral valvuloplasty in patients who were in AF, whereas they signifi cantly decreased in patients who were in sinus rhythm -thus showing the triggering effect of AF on BNP secretion. BNP is secreted from the atria, albeit less so than ANP, and there is some speculation that left atrial stretch may contribute to serum BNP levels.…”

Section: Mitral Stenosis (Ms)mentioning

confidence: 95%

“…All studies concerning serum levels of BNP and NT-proBNP in mitral stenosis (MS) report a marked increase in the levels of these peptides in MS. (21)(22)(23) There are different reasons for this increase. Many of these patients are in atrial fi brillation (AF), which is known to be associated with increased levels.…”

Section: Mitral Stenosis (Ms)mentioning

confidence: 99%

Serum brain natriuretic peptide (BNP) and N-terminal brain natriuretic peptide (NT-proBNP) in heart valve disease

Moolman

Preez

Rossouw

2017

SAHJ

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Serum levels of natriuretic peptides (BNP and NT-proBNP) are known to increase in cardiac failure, and aid in the diagnosis and management of such patients. BNP and NT-proBNP also increase in patients with heart valve lesions, and may contribute to the assessment and management of these patients. There appears to be a general trend towards higher BNP values in more severe heart valve lesions, but the exact implication of a raised BNP or NTproBNP appears to be different for each specifi c valve lesion. In aortic valve stenosis increased levels of BNP/NT-proBNP correlate with the degree of stenosis, symptoms and prognosis. In addition, the increased natriuretic peptide levels seem to refl ect left ventricular dysfunction, as high levels predict poor long-term outcomes in conservatively treated patients as well as post-operative death and poor functional recovery in those who survive the valve replacement procedure. In mitral regurgitation natriuretic peptide levels correlate with the degree of valvular regurgitation, and seem to refl ect subclinical left ventricular dysfunction. Serum natriuretic peptide levels are elevated in patients with mitral stenosis, and correlate with the degree of valvular stenosis and increased pulmonary pressure. Serum levels of natriuretic peptides are elevated in other heart valve lesions, such as aortic valve regurgitation, as well as different forms of mixed valvular disease, but very little is ABSTRACT BNP AND NT-proBNP IN HEART VALVE DISEASE known about the relationship between the serum levels of natriuretic peptides and the latter valve lesions. The practical application of our knowledge concerning serum natriuretic peptides and heart valve disease is limited at this stage, and no specifi c cut-off values to guide patient management have been incorporated into any offi cial guidelines as yet. This review aims to summarise current knowledge on serum BNP and NT-proBNP levels in patients with heart valve disease. The impact of this information on current clinical decision making in patients with different heart valve lesions, as well as evolving concepts concerning its potential future use, will be discussed.

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Serum N‐Terminal pro‐BNP Levels Correlate with Symptoms and Echocardiographic Findings in Patients with Mitral Stenosis

Cited by 47 publications

References 30 publications

The change in NT-pro-BNP and post-PTMC echocardiography parameters in patients with mitral stenosis. A pilot study

The change in NT-pro-BNP and post-PTMC echocardiography parameters in patients with mitral stenosis. A pilot study

The Effect of Percutaneous Balloon Mitral Valvuloplasty on N-Terminal- Pro B- Type Natriuretic Peptide Plasma Levels in Mitral Stenosis

Serum brain natriuretic peptide (BNP) and N-terminal brain natriuretic peptide (NT-proBNP) in heart valve disease

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