European Heart Journal Advance Access originally published online on March 21, 2005
European Heart Journal 2005 26(10):1023-1030; doi:10.1093/eurheartj/ehi236
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Relation of N-terminal pro B-type natriuretic peptide to progression of aortic valve disease
Department of Cardiology, Kerckhoff Heart Center, Benekestraße 2-8, 61231 Bad Nauheim, Germany
Received 16 September 2004; revised 18 February 2005; accepted 24 February 2005; online publish-ahead-of-print 21 March 2005.
* Corresponding author. Tel: +49 6232 9960; fax:+49 6232 9962313. E-mail address: m.weber{at}kerckhoff-klinik.de
See page 951 for the editorial comment on this article (doi:10.1093/eurheartj/ehi216)
Aims Recently an elevation of B-type natriuretic peptide (BNP) and its N-terminal fragment (NT-proBNP) in patients with aortic stenosis (AS) and aortic regurgitation (AR) has been described. The objective of this study was to evaluate the relation of NT-proBNP values to the progression of aortic valve disease.
Methods and results One hundred and sixty-eight patients were included. NT-proBNP was elevated in patients with AS (n=109) and AR (n=37) linked to disease severity. Values for NT-proBNP, pressure gradient, and left ventricular mass were identical in patients (n=22) after previous valve replacement and in those patients with mild AS. NT-proBNP levels decreased in 86 patients after valve replacement (2292±353 vs. 785±101 pg/ml; P<0.01) but increased in 82 patients who were treated conservatively (616±120 vs. 1155±432 pg/mL; P=0.029), related to the progression of disease.
Conclusion NT-proBNP is elevated in patients with aortic valve disease linked to disease severity and decreases after successful surgical therapy but increases in conservatively treated patients. These data underline the consistent relation of NT-proBNP to severity of aortic valve disease. Therefore, NT-proBNP should be considered as a biomarker for the monitoring of disease during follow-up, but further studies are warranted.
Key Words: Natriuretic peptide B-type natriuretic peptide Aortic valve disease Aortic valve replacement
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