B-type natriuretic peptide is synthesized in response to increased ventricular wall stress (WS) and hypertrophy. To serially evaluate aminoterminal-pro-BNP (NT-pBNP) serum levels in patients undergoing aortic valve replacement (AVR) for severe chronic aortic regurgitation (AR), blood samples were drawn preoperatively, 15 days postoperatively, at 6- and 12-month follow-up in 25 consecutive patients. Two-dimensional echocardiography was performed concomitantly, assessing left ventricular (LV) dimensional and functional parameters, including WS. Correlations between NT-pBNP, clinical and echocardiographic data were assessed by non-parametric statistics. Median preoperative NT-pro-BNP was 276 pgyml (IQR = 85 - 1056), being normal or mildly increased in 20 patients, overly increased in five. The most significant correlations of preoperative NT-pBNP were with diastolic (r = 0.80, P < 0.001) and systolic (r = 0.75, P < 0.001) meridional WS and inversely with time from symptom onset (r = -0.67, P = 0.001). NT-pBNP increased 15 days postoperatively (568 pgyml, P = 0.006 vs. preoperative), then decreased at 6 months (144 pgyml, P < 0.001) to remain stable at 1 year (108 pg/ml, P = 0.16). Long-term follow-up NT-pBNP showed direct correlation with diastolic WS (r = 0.56, P = 0.02). Higher preoperative levels of NT-pBNP predicted greater magnitude of total LV mass regression at follow-up (r = -0.65, P = 0.002) independent of preoperative LV mass index, showing that NT-pBNP may have a potential prognostic usefulness in adjunct to echocardiography. © 2008 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.

Preoperative, postoperative and 1-year follow-up N-terminal pro-B-type natriuretic peptide levels in severe chronic aortic regurgitation: Correlations with echocardiographic findings

Santarpino G.;
2008-01-01

Abstract

B-type natriuretic peptide is synthesized in response to increased ventricular wall stress (WS) and hypertrophy. To serially evaluate aminoterminal-pro-BNP (NT-pBNP) serum levels in patients undergoing aortic valve replacement (AVR) for severe chronic aortic regurgitation (AR), blood samples were drawn preoperatively, 15 days postoperatively, at 6- and 12-month follow-up in 25 consecutive patients. Two-dimensional echocardiography was performed concomitantly, assessing left ventricular (LV) dimensional and functional parameters, including WS. Correlations between NT-pBNP, clinical and echocardiographic data were assessed by non-parametric statistics. Median preoperative NT-pro-BNP was 276 pgyml (IQR = 85 - 1056), being normal or mildly increased in 20 patients, overly increased in five. The most significant correlations of preoperative NT-pBNP were with diastolic (r = 0.80, P < 0.001) and systolic (r = 0.75, P < 0.001) meridional WS and inversely with time from symptom onset (r = -0.67, P = 0.001). NT-pBNP increased 15 days postoperatively (568 pgyml, P = 0.006 vs. preoperative), then decreased at 6 months (144 pgyml, P < 0.001) to remain stable at 1 year (108 pg/ml, P = 0.16). Long-term follow-up NT-pBNP showed direct correlation with diastolic WS (r = 0.56, P = 0.02). Higher preoperative levels of NT-pBNP predicted greater magnitude of total LV mass regression at follow-up (r = -0.65, P = 0.002) independent of preoperative LV mass index, showing that NT-pBNP may have a potential prognostic usefulness in adjunct to echocardiography. © 2008 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.
2008
Amino-terminal B-type natriuretic peptide; Aortic valve replacement; B-type natriuretic peptide; Chronic aortic regurgitation; Left ventricular remodeling; Postoperative left ventricular mass regression; Adult; Aortic Valve Insufficiency; Biomarkers; Chronic Disease; Female; Follow-Up Studies; Humans; Male; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; Postoperative Period; Predictive Value of Tests; Preoperative Care; Prospective Studies; Severity of Illness Index; Time Factors; Treatment Outcome; Ultrasonography; Ventricular Remodeling; Heart Valve Prosthesis Implantation; Ventricular Function, Left
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.12317/60521
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