title: Association of NT-proBNP with severity of heart valve disease in a medical patient population presenting with acute dyspnea or peripheral edema.
abstract: OBJECTIVE
  The study aim was to perform a comprehensive evaluation of the association between N-terminal pro B-type natriuretic peptide (NT-proBNP) and the severity of heart valve diseases in a typical clinical population presenting with acute dyspnea or peripheral edema.
  
  
  METHODS
  Among 401 eligible patients, 210 demonstrated evaluable complete echocardiographic examinations. Plasma levels of NT-proBNP were measured after the initial clinical evaluation.
  
  
  RESULTS
  Patients with a prior valve replacement had higher plasma levels of NT-proBNP (median 3,366 pg/ml; n = 10) compared to all other patients (median 931 pg/ml; n = 200) (p < 0.05). In univariable analyses, NT-proBNP levels correlated with multiple valve diseases (r = 0.5; p < 0.001) and the severities of specific heart valve diseases, including aortic valve stenosis (AS) and regurgitation (AR), tricuspid (TR) and mitral valve regurgitation (MR) (p < 0.001). Within multivariable linear regression models, multiple heart valve diseases (Beta = 0.21; T = 3.56; p = 0.0001) and specifically valve regurgitations (AR (Beta = 0.16; T = 2.54; p = 0.012), MR (Beta = 0.36; T = 5.55; p = 0.0001), TR (Beta = 0.17; T = 2.55; p = 0.012)) were associated with increasing plasma levels of NT-proBNP. Patients with NT-proBNP plasma levels > 1,100 pg/ml showed the highest risk for future clinical events (odds ratio (OR) 4.86; p = 0.02), followed by patients with TR (OR 3.17; p = 0.03) and AS (OR 3.49; p = 0.06).
  
  
  CONCLUSIONS
  In addition to clinical assessment and echocardiographic evaluation, the measurement of plasma NT-proBNP levels may serve as a valuable additional indicator of the severity of heart valve disease in individual patients.
authors.affiliation: First Department of Medicine, Institute of Clinical Chemistry, Mannheim, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Behnes
authors.forename: Siegfried
authors.initials: S
authors.lastname: Lang
authors.forename: Ole-A
authors.initials: OA
authors.lastname: Breithardt
authors.forename: Jens J
authors.initials: JJ
authors.lastname: Kaden
authors.forename: Dariusch
authors.initials: D
authors.lastname: Haghi
authors.forename: Parviz
authors.initials: P
authors.lastname: Ahmad-Nejad
authors.forename: Elif
authors.initials: E
authors.lastname: Elmas
authors.forename: Christian
authors.initials: C
authors.lastname: Wolpert
authors.forename: Martin
authors.initials: M
authors.lastname: Borggrefe
authors.forename: Michael
authors.initials: M
authors.lastname: Neumaier
authors.forename: Martina
authors.initials: M
authors.lastname: Brueckmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D004417:Dyspnea / Q000097:blood* / Q000000981:diagnostic imaging; D004452:Echocardiography; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D004489:Edema, Cardiac / Q000097:blood* / Q000000981:diagnostic imaging; D005260:Female; D006333:Heart Failure / Q000097:blood*; D006349:Heart Valve Diseases / Q000097:blood* / Q000000981:diagnostic imaging / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011183:Postoperative Complications / Q000097:blood / Q000000981:diagnostic imaging; D011379:Prognosis; D012008:Recurrence; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain