title: The change in NT-pro-BNP and post-PTMC echocardiography parameters in patients with mitral stenosis. A pilot study.
abstract: BACKGROUND
  The change in the level of NT-pro-BNP (N-terminal-pro-Brain Natriuretic Peptide) is now considered as a reflection of the hemodynamic alterations and its circulatory reductions reported early after successful PTMC (percutaneous transvenous mitral commissurotomy). The present study aims to assess the change in the level of NT-pro BNP following PTMC in patients with mitral stenosis and also to determine the association between circulatory NT-pro-BNP reduction and post-PTMC echocardiography parameters.
  
  
  METHODS
  Twenty five symptomatic consecutive patients with severe MS undergoing elective PTMC were prospectively enrolled. All patients underwent echocardiography before and also 24 to 48 hours after PTMC. Peripheral blood samples were taken for measurement of NT-pro-BNP before as well as 24 to 48 hours after PTMC. The patients were also classified in group with normal sinus rhythm or having atrial fibrillation (AF) based on their 12-lead electrocardiogram.
  
  
  RESULTS
  It was shown a significant decrease in the parameters of PPG (Peak Pressure Gradient), MPG (Mean Pressure Gradient), PHT (Pressure Half Time), PAP (Pulmonary Arterial Pressure), LAV (Left Atrial Volume), and also a significant increase in MVA (Mitral Valve Area) RVS (Right Ventricular S velocity), and strains of lateral, septal, inferior and anterior walls of LA following PTMC. The mean LVEF remained unchanged after PTMC. The mean NT-pro-BNP before PTMC was 309.20 ± 17.97 pg/lit that significantly diminished after PTMC to 235.72 ± 22.46 pg/lit (p = 0.009). Among all echocardiography parameters, only MPG was positively associated with the change in NT-pro-BNP after PTMC. Comparing the change in echocardiography indices between the patients with normal rhythm and those with AF, lower change in PAP was shown in the group with AF. However, more change in the level of NT-pro-BNP after PTMC was shown in the patients with AF compared to those without this arrhythmia.
  
  
  CONCLUSIONS
  PTMC procedure leads to reduce the level of NT-pro-BNP. The change in NT-pro-BNP is an indicator for change in MS severity indicated by decreasing MPG parameter. Lower change in PAP as well as higher change in NT-pro-BNP is predicted following PTMC in the group with AF compared to those with normal sinus rhythm.
authors.affiliation: Cardiovascular Research Center, Modarres Hospital, ShahidBeheshti University of Medical Sciences, Tehran, Iran (Islamic Republic of).
authors.forename: Morteza
authors.initials: M
authors.lastname: Safi
authors.affiliation: Cardiovascular Research Center, Modarres Hospital, ShahidBeheshti University of Medical Sciences, Tehran, Iran (Islamic Republic of).
authors.forename: Fariba
authors.initials: F
authors.lastname: Bayat
authors.affiliation: Cardiovascular Research Center, Modarres Hospital, ShahidBeheshti University of Medical Sciences, Tehran, Iran (Islamic Republic of).
authors.forename: Zahra
authors.initials: Z
authors.lastname: Ahmadi
authors.affiliation: Cardiovascular Research Center, Modarres Hospital, ShahidBeheshti University of Medical Sciences, Tehran, Iran (Islamic Republic of).
authors.forename: Masood
authors.initials: M
authors.lastname: Shekarchizadeh
authors.affiliation: Cardiovascular Research Center, Modarres Hospital, ShahidBeheshti University of Medical Sciences, Tehran, Iran (Islamic Republic of).
authors.forename: Isa
authors.initials: I
authors.lastname: Khaheshi
authors.affiliation: Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran (Islamic Republic of). Students Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Naderian
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D006348:Cardiac Surgical Procedures / Q000379:methods*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008946:Mitral Valve Stenosis / Q000097:blood* / Q000000981:diagnostic imaging* / Q000601:surgery*; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D010865:Pilot Projects; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Echocardiography; Mitral Valve Stenosis; pro-brain natriuretic peptide