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

Int J Cardiovasc Imaging. 2007 Apr;23(2):159-65. doi: 10.1007/s10554-006-9138-z. Epub 2006 Aug 29.

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.

MeSH terms

  • Aged
  • Biomarkers / blood
  • Diastole
  • Echocardiography, Transesophageal
  • Female
  • Follow-Up Studies
  • Heart Atria / diagnostic imaging
  • Heart Failure / blood*
  • Heart Failure / etiology
  • Heart Failure / pathology
  • Heart Failure / physiopathology*
  • Heart Failure / surgery
  • Heart Ventricles / diagnostic imaging
  • Humans
  • Male
  • Middle Aged
  • Mitral Valve / surgery*
  • Mitral Valve Insufficiency / blood
  • Mitral Valve Insufficiency / complications
  • Mitral Valve Insufficiency / physiopathology
  • Mitral Valve Insufficiency / surgery*
  • Myocardial Contraction
  • Natriuretic Peptide, Brain / blood*
  • Organ Size
  • Peptide Fragments / blood*
  • Prognosis
  • Prospective Studies
  • Severity of Illness Index
  • Systole
  • Time Factors
  • Treatment Outcome
  • Ventricular Function, Left*
  • Ventricular Remodeling

Substances

  • Biomarkers
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain