Usefulness of NT-proBNP in the assessment of patients with aortic or mitral regurgitation.
BACKGROUND
Recent application of brain natriuretic peptide and N-terminal prohormone brain natriuretic peptide (NT-proBNP) in cardiac valvular disease is very promising.


OBJECTIVE
To test the usefulness of NT-proBNP in the assessment of patients with aortic or mitral regurgitation.


METHODS
Sixty-seven patients - 23 with aortic and 12 with mitral regurgitation vs. 32 controls - were examined by color Doppler echocardiography, cardiopulmonary exercise testing, Minnesota Living with Heart Failure Questionnaire (MLWHFQ) and plasma NT-proBNP assay at rest (T0) and after maximal physical exercise (T1).


RESULTS
NT-proBNP was significantly higher in patients than in controls, both at T0 (298 +/- 85 vs. 46 +/- 11 pg/ml; P < 0.01) and at T1 (366 +/- 106 vs. 50 +/- 12 pg/ml; P < 0.01). MLWHFQ score was significantly higher in patients (19 +/- 3 vs. 1 +/- 0.6; P < 0.001) with a significant inverse correlation with VO2max (r = -0.538, P < 0.001) and a direct correlation with NT-proBNP (T0: r = 0.415, P < 0.01; T1: r = 0.458, P < 0.01). NT-proBNP was inversely correlated with VO2max (T0: r = -0.444, P < 0.001; T1:r = -0.428, P < 0.001) and directly correlated with left atrial diameter (T0: r = 0.370, P < 0.01; T1: r = 0.409, P = 0.001), and left ventricular mass index (r = 0.279, P < 0.01, and r = 0.272, P < 0.01). No correlations were found between echocardiographic parameters of valvular disease severity and VO2max, NT-proBNP and MLWHFQ.


CONCLUSIONS
NT-proBNP is useful in the assessment of the cardiac functional damage secondary to mitral and aortic regurgitation.
Petracca
Floriana
F
Department of Internal Medicine, Italy.
Affuso
Flora
F
Di Conza
Pasquale
P
Micillo
Filomena
F
Castellano
Graziella
G
Guardasole
Vincenzo
V
Scopacasa
Francesco
F
Saccà
Luigi
L
Fazio
Serafino
S
D001022:Aortic Valve Insufficiency / Q000097:blood* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D015444:Exercise / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000097:blood* / Q000503:physiopathology; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010101:Oxygen Consumption; D010446:Peptide Fragments / Q000097:blood*
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain