Abstract
B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are both secreted primarily from the ventricle myocardium in response to the increase in volume and pressure. We aimed to investigate the relationship between the severity of mitral stenosis (MS) and the level of plasma BNP. A total of 56 patients (50 female, 6 male) were included in the study. Mitral stenosis and its related parameters were evaluated by echocardiographic methods. Patients were divided into three groups as with mild, moderate and severe MS according to their planimetric valvular area. Plasma BNP levels were measured using “Triage-B-type natriuretic peptide test” method (Biosite Diagnostics, San Diego). The relationship of BNP with mitral stenosis and other echocardiographic parameters were studied. The comparison of the 3 groups with one another revealed that the BNP level in the group with moderate MS was higher than that in the group with mild MS, however it was statistically insignificant (74.9 ± 49.7 versus 49.9 ± 40.5 pg/ml, p > 0.05). BNP level in the group with severe MS was significantly higher than that in the mild MS (144.3 ± 83.9 versus 49.9 ± 40.5 pg/ml, p < 0.001) and that in the moderate MS group (144.3 ± 83.9 versus. 74.9 ± 49.7 pg/ml, p < 0.05). When patients were taken together, as the area of the mitral valve decreased, the level of BNP underwent a corresponding increase (r:−0.48, p < 0.001). We have ascertained that the level of plasma BNP and the degree of MS are significantly correlated, and as MS becomes more serious, the plasma BNP level rises.
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Maisel AS, Krisnaswamy P, Nowak RM, et al (2002) Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N England J Med 347:161–7
Munagala VK, Burnett JC, Redfield MM (2004) The natriuretic peptides in cardiovascular medicine. Curr Prob Cardiol 29:707–69
Dao Q, Krishnaswamy P, Kazanegra R, et al (2001) Utility of B-type natriuretic peptide in diagnosis of congestive heart failure in an urgent-care setting. J Am Coll Cardiol 37:379–85
Nelson CA, Case C, McCrohon J, Marwick TH (2005) Relationship of extent and nature of dysfunctional myocardium to brain natriuretic peptide in patients with ischemic left ventricular dysfunction. Int J Cardiovasc Imaging 21:295–300
Feringa HH, Poldermans D, Klein P, Braun J, Klautz RJ, van Domburg RT, et al (2006) Plasma natriuretic peptide levels reflect changes in heart failure symptoms, left ventricular size and function after surgical mitral valve repair. Int J Cardiovasc Imaging [Epub ahead of print]
Rawlins ML, Owen WE, Roberts WL (2005) Performance characteristics of four automated natriuretic peptide assays. Am J Clin Pathol 123:439–445
Yu CM, Sanderson JE, Shum IO, et al (1996) Diastolic dysfunction and natriuretic peptides in systolic heart failure: higher ANP and BNP levels are associated with restrictive filling pattern. Eur Heart J 17:1694–1702
Talwar S, Squire IB, Downie PF, et al (2000) Profile of plasma N-terminal proBNP following acute myocardial infarction correlation with left ventricular systolic dysfunction. Eur Heart J 21:1514–1521
Kruger S, Graft J, Merx MW (2004) Brain natriuretic peptide predicts right heart failure in patients with acute pulmonary embolism. Am Heart J 147:60–65
Nagaya N, Nishikimi T, Okano Y, et al (1998) Plasma brain natriuretic peptide levels increase in proportion to the extent of right ventricular dysfunction in pulmonary hypertension. J Am Coll Cardiol 31:202–208
Leuchte HH, Holzapfel M, Baumgartner RA, et al (2004) Clinical significance of brain natriuretic peptide in primary pulmonary hypertension. J Am Coll Cardiol 43:764–770
Wang A,Ryan T, Kisslo KB, Bashore TM, Harrison JK (1999) Assessing the severity of mitral stenosis: Variability between noninvasive and invasive measurements in patients with symptomatic mitral valve stenosis. Am Heart J 138:777–784
Taylor R, EdD, RDCS. Assessing mitral stenosis with Doppler echocardiography: limitations of the pressure half-time method. (1990) J Diag Med Sonograp 6:219–223
Mohan JC, Mukherjee S, Kumar A, Arora R, Patel AR (2004) Does chronic mitral regurgitation influence Doppler pressure half-time–derived calculation of the mitral valve area in patients with mitral stenosis? Am Heart J 148:703–709
Rifkin RD, Harper K, Tighe D (1995) Comparison of proximal isovelocity surface area method with pressure half-time and planimetry in evaluation of mitral stenosis. J Am Col Cardiol 26:458–465
Bennis A, Drighil A, Tribouilloy C, Drighil A, Chraibi N (2002) Clinical application in routine practice of the proximal flow convergence method to calculate the mitral surface area in mitral valve stenosis. Int J Cardiovasc Imaging 18:443–451
Uzun M, Baysan O, Erinc K, Ozkan M, Sag C, Genc C, et al (2005) A simple different method to use proximal isovelocity surface area (PISA) for measuring mitral valve area. Int J Cardiovasc Imaging 21:633–640
Arat-Ozkan A, Kaya A, Yigit Z, et al (2005) N-terminal pro-BNP levels correlate with symptoms and echocardiographic findings in patients with mitral stenosis. Echocardiography 22:473–478
Iltumur K, Karabulut A, Yokus B, Yavuzkir M, Taskesen T, Toprak N (2005) N-terminal proBNP plasma levels correlate with severity of mitral stenosis. J Heart Valve Dis 14:735–741
Borgeson DD, Seward JB, Miller FA Jr, Oh JK, Tajik AJ (1996) Frequency of Doppler measurable pulmonary artery pressures. J Am Soc Echocardiogr 9:832–837
Redfield MM, Rodeheffer RJ, Jacobsen SJ, Mahoney DW, Bailey KR, Burnett JC Jr (2002) Plasma brain natriuretic peptide concentration: impact of age and gender. J Am Coll Cardiol 40:976–982
Mair J, Friedl W, Thomas S, Puschendorf B (1999) Natriuretic peptides in assessment of left ventricular dysfunction. Scand J Clin Lab Invest 230:132–142
Mayer SA, Lemos J, Murphy SA, Brooks S, Roberts BJ, Grayburn PA (2004) Comparision of B-type natriuretic peptide levels in patients with heart failure with versus without mitral regurgitation. Am J Cardiol 93:1002–1006
Eimer MJ, Ekery DL, Rigolin VH, Bonow RO, Carnethon MR, Cotts WG (2004) Elevated B-type natriuretic peptide in asymptomatic men with chronic aortic regurgitation and preserved left ventricular systolic function. Am J Cardiol 94:676–678
Weber M, Arnold R, Rau M, et al (2004) Relation of N terminal Pro-BNP type natriuretic peptide to severity of valvular aortic stenosis. Am J Cardiol 94:740–745
Vasan RS, Benjamin EJ, Larson MG, et al (2002) Plasma natriuretic peptides for community screening for left ventricular hypertrophy and systolic dysfunction The Framingham Heart Study. JAMA 288:1252–1259
Freitag MH, Larson MG, Levy D, et al (2003) Plasma brain natriuretic peptide levels and blood pressure tracking in the framingham heart study. Hypertension 41:978–983
Inoue S, Murakami Y, Katoh H, Shimada T (2000) Atrium as a source of brain natriuretic peptide in patients with atrial fibrillation. J Card Failure 6:92–96
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Eryol, N.K., Dogan, A., Ozdogru, I. et al. The relationship between the level of plasma B-type natriuretic peptide and mitral stenosis. Int J Cardiovasc Imaging 23, 569–574 (2007). https://doi.org/10.1007/s10554-006-9174-8
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DOI: https://doi.org/10.1007/s10554-006-9174-8