title: Clinical and echocardiographic correlates of plasma B-type natriuretic peptide levels in patients with aortic valve stenosis and normal left ventricular ejection fraction.
abstract: BACKGROUND
  Several studies suggest that BNP testing may help define the timing of aortic valve surgery in patients with aortic valve stenosis (AVS) prior onset of overt LV systolic dysfunction. The aim of this study was to identify clinical and echocardiographic correlates of plasma BNP levels in a large cohort of patients with AVS and preserved LV ejection fraction.
  
  
  RESULTS
  One hundred thirty-five consecutive patients were prospectively included in the present study (Mean age 73 ± 13 years old, 66 (49%) male). Eighty-nine patients (66%) had severe AVS (aortic valve area <0.6 cm(2) /m(2) BSA). Plasma BNP levels, clinical and comprehensive Doppler echocardiography evaluation was performed in all patients. Independent clinical correlates of plasma BNP levels (R(2) = 0.19) were older age (P < 0.0001) and presence of AVS symptoms (P = 0.004). Independent echocardiographic correlates of plasma BNP levels (R(2) = 0.38) were E/Ea ratio (P = 0.01), LV mass index (P = 0.018), left atrial surface (P < 0.0001) and systolic pulmonary artery pressure (sPAP; P = 0.004). Overall, independent correlates of plasma BNP levels (R(2) = 0.47) were older age (P = 0.001), known coronary artery disease (P = 0.047), increased LV mass index (P = 0.001), left atrial enlargement (P = 0.002), and increased sPAP (P = 0.003).
  
  
  CONCLUSIONS
  In patients with AVS and normal LV ejection fraction, plasma BNP predominantly reflects the clinical and echocardiographic consequences of afterload burden imposed on the left ventricle rather than the severity of valve stenosis, per se.
authors.affiliation: Hospital Group of the Lille Catholic Institute, Catholic University of Lille, Lille, France.
authors.forename: Sylvestre
authors.initials: S
authors.lastname: Maréchaux
authors.forename: Mehdi
authors.initials: M
authors.lastname: Hattabi
authors.forename: Francis
authors.initials: F
authors.lastname: Juthier
authors.forename: Dan Valentin
authors.initials: DV
authors.lastname: Neicu
authors.forename: Marjorie
authors.initials: M
authors.lastname: Richardson
authors.forename: Emilie
authors.initials: E
authors.lastname: Carpentier
authors.forename: Nadia
authors.initials: N
authors.lastname: Bouabdallaoui
authors.forename: François
authors.initials: F
authors.lastname: Delelis
authors.forename: Carlo
authors.initials: C
authors.lastname: Banfi
authors.forename: Joke
authors.initials: J
authors.lastname: Breyne
authors.forename: Brigitte
authors.initials: B
authors.lastname: Jude
authors.forename: Philippe
authors.initials: P
authors.lastname: Asseman
authors.forename: André
authors.initials: A
authors.lastname: Vincentelli
authors.forename: Thierry
authors.initials: T
authors.lastname: Le Tourneau
authors.forename: Pierre
authors.initials: P
authors.lastname: Graux
authors.forename: Philippe
authors.initials: P
authors.lastname: Pibarot
authors.forename: Pierre Vladimir
authors.initials: PV
authors.lastname: Ennezat
mesh_terms: D000368:Aged; D001024:Aortic Valve Stenosis / Q000097:blood* / Q000000981:diagnostic imaging*; D015415:Biomarkers / Q000097:blood; D015897:Comorbidity; D017023:Coronary Angiography; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011446:Prospective Studies; D011669:Pulmonary Wedge Pressure; D012044:Regression Analysis; D012307:Risk Factors; D013318:Stroke Volume
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain