Relation of N-terminal pro B-type natriuretic peptide to progression of aortic valve disease.
OBJECTIVE
Recently an elevation of B-type natriuretic peptide (BNP) and its N-terminal fragment (NT-proBNP) in patients with aortic stenosis (AS) and aortic regurgitation (AR) has been described. The objective of this study was to evaluate the relation of NT-proBNP values to the progression of aortic valve disease.


RESULTS
One hundred and sixty-eight patients were included. NT-proBNP was elevated in patients with AS (n=109) and AR (n=37) linked to disease severity. Values for NT-proBNP, pressure gradient, and left ventricular mass were identical in patients (n=22) after previous valve replacement and in those patients with mild AS. NT-proBNP levels decreased in 86 patients after valve replacement (2292+/-353 vs. 785+/-101 pg/ml; P<0.01) but increased in 82 patients who were treated conservatively (616+/-120 vs. 1155+/-432 pg/mL; P=0.029), related to the progression of disease.


CONCLUSIONS
NT-proBNP is elevated in patients with aortic valve disease linked to disease severity and decreases after successful surgical therapy but increases in conservatively treated patients. These data underline the consistent relation of NT-proBNP to severity of aortic valve disease. Therefore, NT-proBNP should be considered as a biomarker for the monitoring of disease during follow-up, but further studies are warranted.
Weber
Michael
M
Department of Cardiology, Kerckhoff Heart Center, Benekestrasse 2-8, 61231 Bad Nauheim, Germany. m.weber@kerckhoff-klinik.de
Arnold
Roman
R
Rau
Matthias
M
Elsaesser
Albrecht
A
Brandt
Roland
R
Mitrovic
Veselin
V
Hamm
Christian
C
D000368:Aged; D001021:Aortic Valve; D001022:Aortic Valve Insufficiency / Q000097:blood* / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000097:blood* / Q000601:surgery; D015415:Biomarkers / Q000378:metabolism; D018450:Disease Progression; D004452:Echocardiography; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D020097:Natriuretic Peptide, Brain; D009419:Nerve Tissue Proteins / Q000378:metabolism*; D010446:Peptide Fragments / Q000378:metabolism*; D011379:Prognosis; D011446:Prospective Studies
D015415:Biomarkers; D009419:Nerve Tissue Proteins; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain