Add like
Add dislike
Add to saved papers

NT-ProBNP as a Potential Marker of Left Atrial Dysfunction in Rheumatic Mitral Stenosis: Correlation with Left Atrial Function after PBMV.

BACKGROUND: Rheumatic heart disease is a common reason for cardiovascular morbidity and mortality. Plasma levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) are known to rise in patients with MS, but the role of this compound as a non-invasive marker of left atrial (LA) dysfunction is yet to be established. The study aim was to correlate levels of NT-proBNP in patients with rheumatic mitral stenosis (MS), with echocardiographic parameters of LA function including tissue Doppler-derived strain/strain rate (S/Sr) indices, hemodynamic parameters of LA function, before and after percutaneous balloon mitral valvotomy (PBMV) for a follow up of one year.

METHODS: The study included 51 patients with severe MS and 10 age- and gender-matched controls. All patients and subjects underwent detailed clinical and echocardiographic evaluation (including LA S/Sr indices) prior to PBMV and at 12 h, one month and one year after PBMV. Venous blood samples were withdrawn to monitor NT-proBNP levels during the same period. LA functions were assessed echocardiographically, using conventional parameters, while S/Sr indices were calculated at mid-LA segments (septal, lateral, anterior and inferior) during ventricular systole, and at early and late diastole. The LA appendage contraction velocity was calculated using transesophageal echocardiography (TEE) and correlated with NT-proBNP levels. The cardiac output (CO) was calculated invasively. The pulmonary capillary wedge pressure (PCWP), pulmonary artery pressure (PAP) and other parameters were correlated with NT-proBNP levels before and after PBMV.

RESULTS: The mean NT-proBNP level before PBMV was 761.76 ± 213.6 pg/ml, and was 425 pg/ml, 300 pg/ml and 50 pg/ml at one day, one month and one year, respectively (p <0.01). The S/Sr indices at each mid-LA segment (septal, lateral, anterior, and inferior) during ventricular systole (LAs), at early (LAe) and late diastole (LAa) were each significantly lower in patients than in controls (p <0.001). The S/Sr values were improved significantly (p <0.05) in most segments at one day and at one month after PBMV, but after one year the values were increased by >50%, in relation to the NT-proBNP level. There were significant falls in mean PAP and PCWP and a rise in CO, each of which correlated significantly with NTproBNP levels.

CONCLUSIONS: NT-proBNP levels correlated significantly with LA dysfunction, and can predict improvements in LA function following PBMV in rheumatic MS for up to one year. Tissue Doppler-derived S/Sr indices may be used to detect fine variations over and above conventional echocardiography, and this may be clinically valuable in the prognosis of MS patients.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app