title: Preoperative, postoperative and one-year follow-up of N-terminal pro-B-type natriuretic peptide levels in volume overload of aortic regurgitation: comparison with pressure overload of aortic stenosis.
abstract: OBJECTIVE
  Limited data are available regarding the impact of pressure or volume overload on the clinical or echocardiographic parameters and the levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with chronic severe aortic valve diseases. We aimed to investigate and compare the relationships between these parameters in such patients.
  
  
  METHODS
  One hundred twenty-four consecutive patients who underwent aortic valve replacement for chronic severe aortic valve diseases were enrolled. Plasma NT- proBNP was measured and echocardiographic parameters were recorded before surgery, before discharge and 12 months after surgery.
  
  
  RESULTS
  NT-proBNP levels were significantly higher in patients with aortic regurgitation (AR) (n = 63) than in those with aortic stenosis (n = 61) (1,836.0 ± 376.1 vs. 508.4 ± 74.5 pg/ml, p = 0.001). There was a significant relationship between NT-proBNP levels and left ventricular mass index (LVMI) in AR (r = 0.436, p = 0.002) and a weaker, but significant, relationship between NT-proBNP levels and LVMI in aortic stenosis patients (r = 0.290, p = 0.046). In the AR group, preoperative NT-proBNP levels positively correlated with LVMI regression during the 12 months after surgery (r = 0.488, p = 0.001).
  
  
  CONCLUSIONS
  NT-proBNP levels may reflect LVMI changes that are caused by volume overload rather than pressure overload in chronic aortic valve diseases. Higher preoperative NT-proBNP levels may predict left ventricular reverse remodeling early after surgery for chronic severe AR.
authors.affiliation: Division of Cardiology, Cardiac and Vascular Center, Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
authors.forename: Bong Gun
authors.initials: BG
authors.lastname: Song
authors.forename: Yong Hwan
authors.initials: YH
authors.lastname: Park
authors.forename: Gu Hyun
authors.initials: GH
authors.lastname: Kang
authors.forename: Woo Jung
authors.initials: WJ
authors.lastname: Chun
authors.forename: Ju Hyeon
authors.initials: JH
authors.lastname: Oh
authors.forename: Jin-Oh
authors.initials: JO
authors.lastname: Choi
authors.forename: Sang-Chol
authors.initials: SC
authors.lastname: Lee
authors.forename: Seung Woo
authors.initials: SW
authors.lastname: Park
authors.forename: Jae K
authors.initials: JK
authors.lastname: Oh
authors.forename: Ki Ick
authors.initials: KI
authors.lastname: Sung
authors.forename: PyoWon
authors.initials: P
authors.lastname: Park
authors.forename: Eun-Seok
authors.initials: ES
authors.lastname: Jeon
mesh_terms: D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000503:physiopathology / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000503:physiopathology / Q000601:surgery; D016009:Chi-Square Distribution; D015897:Comorbidity; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000378:metabolism*; D010446:Peptide Fragments / Q000378:metabolism*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000503:physiopathology / Q000601:surgery
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain