Plasma natriuretic peptide levels reflect changes in heart failure symptoms, left ventricular size and function after surgical mitral valve repair.
OBJECTIVE
N-terminal pro-B-type natriuretic peptide (NT-proBNP) has diagnostic and prognostic value in patients with heart failure. The present prospective study was designed to assess whether changes in NT-proBNP levels after surgical mitral valve repair reflect changes in heart failure symptoms and changes in left atrial size, left ventricular size and left ventricular function.


METHODS
The study population consisted of 22 patients (mean age: 62.8 +/- 14.2 years, 68% male) undergoing surgical mitral valve repair. Serial NT-proBNP measurements, transthoracic echocardiography and New York Heart Association (NYHA) class assessment were performed before and 6 months after surgery.


RESULTS
All patients underwent successful mitral valve repair and no patients died during follow-up. The decrease in NT-proBNP level was associated with the reduction in left atrial dimension (r = 0.72, P < 0.001), left ventricular end-systolic dimension (r = 0.63, P = 0.002), left ventricular end-diastolic dimension (r = 0.46, P = 0.031), and the increase in fractional shortening (r = - 0.63, P = 0.002). Finally, patients with decreasing NT-proBNP levels revealed a significant improvement in heart failure symptoms (NYHA class).


CONCLUSIONS
Changes in NT-proBNP after surgical mitral valve repair reflect changes in heart failure symptoms and changes in left atrial and ventricular dimensions and function.
Feringa
Harm H H
HH
Department of Cardiothoracic Surgery/Cardiology, C-5, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands. h.feringa@erasmusmc.nl
Poldermans
Don
D
Klein
Patrick
P
Braun
Jerry
J
Klautz
Robert J M
RJ
van Domburg
Ron T
RT
van der Laarse
Arnoud
A
van der Wall
Ernst E
EE
Dion
Robert A E
RA
Bax
Jeroen J
JJ
D000368:Aged; D015415:Biomarkers / Q000097:blood; D003971:Diastole; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000000981:diagnostic imaging; D006333:Heart Failure / Q000097:blood* / Q000209:etiology / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000097:blood / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D009200:Myocardial Contraction; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009929:Organ Size; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D013599:Systole; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain