Utility of NT-pro-BNP in patients undergoing transapical aortic valve replacement.
BACKGROUND
Transapical aortic valve replacement (TAVR) is increasingly being applied in conventionally inoperable patients with aortic stenosis. The utility of the cardiac marker NT-pro-BNP has yet not been assessed in this setting.


METHODS
NT-pro-BNP was assessed preoperatively, postoperatively (day 1, 3, 5 and 8) and 2 months after the intervention in 31 consecutive patients (13 men, 18 women; median age 84) undergoing TAVR and the association with baseline characteristics and outcome was analysed.


RESULTS
Baseline NT-pro-BNP was associated with baseline creatinine, left-ventricular mass index and NYHA class and predicted regression of LV-mass after 2 months. There was no correlation of NT-pro-BNP with measures of the aortic valve function before or after replacement. The increase of NT-pro-BNP 3 days after TAVR was inversely associated with a functional improvement of >or=1 NYHA class at 2 months. Baseline NT-pro-BNP was not associated with 2-month mortality and major adverse events (death/neurological deficit), whereas the postoperative increase of NT-pro-BNP after TAVR showed a slightly significant inverse and the EuroSCORE a significant correlation.


CONCLUSIONS
In multimorbid patients undergoing TAVR, NT-pro-BNP independently predicted regression of LV-mass after 2 months and early decrease of NT-pro-BNP postoperatively indicated improvement of functional capacity at 2 months. There was no association of NT-pro-BNP with 2-month mortality.
Department of Internal Medicine III, Herzzentrum, University of Cologne, Kerpenerstr. 62, 50937, Cologne, Germany. roman.pfister@uk-koeln.de
Roman
R
Pfister
Thorsten
T
Wahlers
Frank M
FM
Baer
Max
M
Scherner
Justus
J
Strauch
Erland
E
Erdmann
D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000097:blood / Q000175:diagnosis* / Q000601:surgery*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain