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Plasma natriuretic peptide levels reflect changes in heart failure symptoms, left ventricular size and function after surgical mitral valve repair

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Abstract

Background and aim

N-terminal pro-B-type natriuretic peptide (NT-proBNP) has diagnostic and prognostic value in patients with heart failure. The present prospective study was designed to assess whether changes in NT-proBNP levels after surgical mitral valve repair reflect changes in heart failure symptoms and changes in left atrial size, left ventricular size and left ventricular function.

Methods

The study population consisted of 22 patients (mean age: 62.8 ± 14.2 years, 68% male) undergoing surgical mitral valve repair. Serial NT-proBNP measurements, transthoracic echocardiography and New York Heart Association (NYHA) class assessment were performed before and 6 months after surgery.

Results

All patients underwent successful mitral valve repair and no patients died during follow-up. The decrease in NT-proBNP level was associated with the reduction in left atrial dimension (r = 0.72, P < 0.001), left ventricular end-systolic dimension (r = 0.63, P = 0.002), left ventricular end-diastolic dimension (r = 0.46, P = 0.031), and the increase in fractional shortening (r =  − 0.63, P = 0.002). Finally, patients with decreasing NT-proBNP levels revealed a significant improvement in heart failure symptoms (NYHA class).

Conclusion

Changes in NT-proBNP after surgical mitral valve repair reflect changes in heart failure symptoms and changes in left atrial and ventricular dimensions and function.

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References

  1. Levin ER, Gardner DG, Samson WK (1998) Natriuretic peptides. N Engl J Med 339:321–328

    Article  PubMed  CAS  Google Scholar 

  2. Hall C (2004) Essential biochemistry and physiology of (NT-pro)BNP. Eur J Heart Fail 6:257–260

    Article  PubMed  CAS  Google Scholar 

  3. Yoshimura M, Yasue H, Okumura K et al. (1993) Different secretion patterns of atrial natriuretic peptide and brain natriuretic peptide in patients with congestive heart failure. Circulation 87:464–469

    PubMed  CAS  Google Scholar 

  4. Yasue H, Yoshimura M, Sumida H et al. (1994) Localization and mechanism of secretion of B-type natriuretic peptide in comparison with those of A-type natriuretic peptide in normal subjects and patients with heart failure. Circulation 90:195–203

    PubMed  CAS  Google Scholar 

  5. Lainchbury JG, Campbell E, Frampton CM et al. (2003) Brain natriuretic peptide and N-terminal brain natriuretic peptide in the diagnosis of heart failure in patients with acute shortness of breath. J Am Coll Cardiol 42:728–735

    Article  PubMed  CAS  Google Scholar 

  6. Gardner RS, Ozalp F, Murday AJ et al. (2003) N-terminal pro-brain natriuretic peptide. A new gold standard in predicting mortality in patients with advanced heart failure. Eur Heart J 24:1735–1743

    Article  PubMed  CAS  Google Scholar 

  7. Bettencourt P, Azevedo A, Pimenta J et al. (2004) N-terminal-pro-brain natriuretic peptide predicts outcome after hospital discharge in heart failure patients. Circulation 110:2168–2174

    Article  PubMed  CAS  Google Scholar 

  8. Nelson CA, Case C, McCrohon J et al. (2005) Relationship of extent and nature of dysfunctional myocardium to brain natriuretic peptide in patients with ischemic left ventricular dysfunction. Int J Cardiovasc Imaging 21:295–302

    Article  PubMed  Google Scholar 

  9. Mayer SA, De Lemos JA, Murphy SA et al. (2004) Comparison of B-type natriuretic peptide levels in patients with heart failure with versus without mitral regurgitation. Am J Cardiol 93:1002–1006

    Article  PubMed  CAS  Google Scholar 

  10. Brookes CI, Kemp MW, Hooper J et al. (1997) Plasma brain natriuretic peptide concentrations in patients with chronic mitral regurgitation. J Heart Valve Dis 6:608–612

    PubMed  CAS  Google Scholar 

  11. Sutton TM, Stewart RA, Gerber IL et al. (2003) Plasma natriuretic peptide levels increase with symptoms and severity of mitral regurgitation. J Am Coll Cardiol 41:2280–2287

    Article  PubMed  CAS  Google Scholar 

  12. Thomas JD (1997) How leaky is that mitral valve? Simplified Doppler methods to measure regurgitant orifice area. Circulation 95:548–555

    PubMed  CAS  Google Scholar 

  13. Yeo KT, Wu AH, Apple FS et al. (2003) Multicenter evaluation of the Roche NT-proBNP assay and comparison to the Biosite Triage BNP assay. Clin Chim Acta 338:107–115

    Article  PubMed  CAS  Google Scholar 

  14. Detaint D, Messika-Zeitoun D, Avierinos JF et al. (2005) B-type natriuretic peptide in organic mitral regurgitation: determinants and impact on outcome. Circulation 111:2391–2397

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiothoracic Surgery/Cardiology, C-5, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands

    Harm H. H. Feringa, Patrick Klein, Jerry Braun, Robert J. M. Klautz, Arnoud van der Laarse, Ernst E. van der Wall, Robert A. E. Dion & Jeroen J. Bax

  2. Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands

    Don Poldermans & Ron T. van Domburg

Authors
  1. Harm H. H. Feringa
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  2. Don Poldermans
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  3. Patrick Klein
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  4. Jerry Braun
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  5. Robert J. M. Klautz
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  6. Ron T. van Domburg
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  7. Arnoud van der Laarse
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  8. Ernst E. van der Wall
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  9. Robert A. E. Dion
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  10. Jeroen J. Bax
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Corresponding author

Correspondence to Harm H. H. Feringa.

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Feringa, H.H.H., Poldermans, D., Klein, P. et al. Plasma natriuretic peptide levels reflect changes in heart failure symptoms, left ventricular size and function after surgical mitral valve repair. Int J Cardiovasc Imaging 23, 159–165 (2007). https://doi.org/10.1007/s10554-006-9138-z

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  • DOI: https://doi.org/10.1007/s10554-006-9138-z

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