title: Correlation to NT-ProBNP and remodeling after cardiac surgery.
abstract: BACKGROUND
  Few data are available on diastolic function in patients with aortic stenosis (AOS) with indication of surgical treatment. A potential correlation between biomarkers and diastolic function has not been established.
  
  
  OBJECTIVE
  The aim of our study was to evaluate diastolic function in patients with AOS waiting for aortic valve replacement (AVR) echocardiographically, and to verify its correlation with serum brain natriuretic peptide (NT-proBNP).
  
  
  METHODS
  Thirty-one AOS patients (11 male), 21 to 81 years old (mean age, 61±15 years old) were studied before and after AVR. Diastolic function was assessed with Doppler methods: transvalvar mitral flow, tissue Doppler imaging (TDI) and pulmonary venous Doppler (PVD), correlating with serum brain natriuretic peptide (NT-proBNP) before and 6 months after AVR.
  
  
  RESULTS
  Comparing pre to post-operative period, we observed an increase of the left atrial ejection fraction and isovolumetric relaxation time (IRT), and the decrease of the mitral velocity to early diastolic velocity of the mitral annulus ratio (E/E'), the difference between the pulmonary A wave duration and mitral A duration, left atrial systolic volume, left atrial systolic volume index, left ventricular diastolic diameter, left ventricular systolic diameter, end diastolic volume (LVEDV), left ventricular mass index, left ventricular volume and mass index ratio. The values of NT-proBNP were positively correlated to diastolic dysfunction, both before and after surgery.
  
  
  CONCLUSIONS
  AOS patients' ventricular diastolic function improved after AVR. The biomarker NT-proBNP might be a useful biomarker of diastolic function in these patients, before and after AVR. NT-proBNP values show a positive correlation with echocardiographic variables that determine diastolic dysfunction, and is a good marker for the characterization of this dysfunction in AOS patients.
authors.affiliation: Instituto do Coração (InCor), São Paulo, SP - Brazil.
authors.forename: Berta Paula Napchan
authors.initials: BP
authors.lastname: Boer
authors.forename: Marcelo Luiz Campos
authors.initials: ML
authors.lastname: Vieira
authors.forename: Roney Orismar
authors.initials: RO
authors.lastname: Sampaio
authors.forename: Henry
authors.initials: H
authors.lastname: Abensur
authors.forename: Alessandra Gomes de
authors.initials: AG
authors.lastname: Oliveira
authors.forename: João Ricardo
authors.initials: JR
authors.lastname: Fernandes
authors.forename: Max
authors.initials: M
authors.lastname: Grinberg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001024:Aortic Valve Stenosis / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D015415:Biomarkers / Q000097:blood; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011184:Postoperative Period; D057234:Preoperative Period; D013318:Stroke Volume / Q000502:physiology; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology; D020257:Ventricular Remodeling / Q000502:physiology*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain