title: The predictive value and evolution of N-terminal pro-B-type natriuretic peptide levels following transcutaneous aortic valve implantation.
abstract: OBJECTIVE
  We sought to define the predictive value and evolution of N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels following transcutaneous aortic valve implantation (TAVI).
  
  
  RESULTS
  We investigated 91 consecutive patients who underwent TAVI (59 transfemoral [TF], 32 transapical [TA]) in our institution. The balloon-expandable valve was implanted in 75 and the self-expanding in 16 patients. The baseline (within 48 hours prior to procedure), early (24-74 hours), and late (3-12 months) postprocedural NT-proBNP levels were determined. The mortality status of all patients was ascertained as of September 2010. The 30-day and 1.3(mean)-year mortality was 3% and 12% (2%, 9% in the TF and 6%, 19% in the TA group). Increased baseline (χ(2) = 5.9, P = 0.016) and early (χ(2) = 4.9, P = 0.028) NT-proBNP levels were predictive of mortality. All decrements of the NT-proBNP levels in the TF patients were significant (baseline 4,984 ± 8,106 vs. early 3,912 ± 6,551 pg/mL, P = 0.016; late 633 ± 606 pg/mL, P = 0.003). In contrast, there was a trend for the early levels to increase in the TA patients (6,423 ± 8,897 vs. 8,100 ± 10,178 pg/mL, P = 0.090), and a significant decline in the late levels as compared to baseline (1,704 ± 3,417 pg/mL, P = 0.005).
  
  
  CONCLUSIONS
  NT-proBNP levels are predictive of mortality following TAVI. There is a differential early evolution of their levels between the TF and TA patients and a significant decline later in both groups.
authors: Hygeia Hospital, 9 Red Cross Street, Athens, Greece. kspargias@hygeia.gr
authors: Konstantinos
authors: K
authors: Spargias
authors: Spyros
authors: S
authors: Polymeros
authors: Antonis
authors: A
authors: Dimopoulos
authors: Athanassios
authors: A
authors: Manginas
authors: Gregory
authors: G
authors: Pavlides
authors: Marina
authors: M
authors: Balanika
authors: Anna
authors: A
authors: Smirli
authors: George
authors: G
authors: Stavridis
authors: George
authors: G
authors: Dangas
authors: Dennis V
authors: DV
authors: Cokkinos
mesh_terms: D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016009:Chi-Square Distribution; D004452:Echocardiography; D005260:Female; D006305:Health Status Indicators; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D013997:Time Factors
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain