title: The effect of percutaneous balloon mitral valvuloplasty on N-terminal- pro B- type natriuretic peptide plasma levels in mitral stenosis.
abstract: The 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 NT-proBNP 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 (beta = -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 NT- proBNP levels in patients with MS may reflect the increased wall stress in the left atrium and right side of the heart.
authors.affiliation: Department of Cardiology, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey.
authors.forename: Mehmet Timur
authors.initials: MT
authors.lastname: Selcuk
authors.forename: Hatice
authors.initials: H
authors.lastname: Selcuk
authors.forename: Orhan
authors.initials: O
authors.lastname: Maden
authors.forename: Ali Riza
authors.initials: AR
authors.lastname: Erbay
authors.forename: Ahmet
authors.initials: A
authors.lastname: Temizhan
authors.forename: Tolga
authors.initials: T
authors.lastname: Aksu
authors.forename: Gul Sevim
authors.initials: GS
authors.lastname: Saydam
authors.forename: Sule
authors.initials: S
authors.lastname: Korkmaz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D002302:Cardiac Output / Q000502:physiology; D002404:Catheterization; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000097:blood* / Q000503:physiopathology / Q000628:therapy*; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011651:Pulmonary Artery / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain