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- Title
Plasma N-terminal pro BNP and cardiotrophin-1 are elevated in aortic stenosis.
- Authors
Talwar, Suneel; Downie, Paul F.; Squire, Iain B.; Davies, Joan E.; Barnett, David B.; Ng, Leong L.; Talwar, S; Downie, P F; Squire, I B; Davies, J E; Barnett, D B; Ng, L L
- Abstract
<bold>Background: </bold>Echocardiography with Doppler examination of the aortic valve provides a very accurate assessment of the transvalvular gradient and is used to monitor progression of aortic stenosis (AS). Plasma brain natriuretic peptide (BNP) has been shown to correlate with end-systolic wall stress in patients with AS.<bold>Aim: </bold>We hypothesized that plasma N-terminal proBNP (NT proBNP) and a newly identified cytokine cardiotrophin-1 (CT-1), which has been shown to stimulate BNP production at a transcriptional level are elevated in patients with AS and correlate to the maximum trans-valvular aortic pressure gradient (TVPG).<bold>Method: </bold>We compared plasma NT proBNP and CT-1 in 15 AS patients [five males, mean age 79 years [range 60-94], mean TPVG 39.3 mmHg (20-100)] with 10 controls (five male, mean age 68 years [56-79]). Results are expressed as mean [ranges] and comparisons were by the Mann-Whitney test.<bold>Results: </bold>NT proBNP levels were elevated in AS patients [252.9 fmol/ml (79.2-541.8)] when compared with the controls (157.2 fmol/ml [104.7-236.9], P<0.005). Also CT-1 levels were elevated in AS patients (57.3 fmol/ml [33-86.3] when compared with the controls [28.3 fmol/ml (6.9-48.3), P<0.0005]. Both NT proBNP and CT-1 levels were correlated to the TVPG (r=0.53 and r=0.65, P<0.05 and P=0.009, respectively). On best subset analysis the strongest correlate with TVPG was CT-1 (R2=38%). The addition of NT proBNP did not improve diagnostic accuracy (R2=39%).<bold>Conclusion: </bold>These results suggest NT proBNP and CT-1 levels increase in proportion to the TVPG and could potentially be used to monitor progression of disease non-invasively. These markers may also be useful to identify the optimum time for surgery in AS.
- Subjects
AORTIC stenosis; DOPPLER echocardiography; BRAIN natriuretic factor; CYTOKINES; ANTISENSE DNA
- Publication
European Journal of Heart Failure, 2001, Vol 3, Issue 1, p15
- ISSN
1388-9842
- Publication type
journal article
- DOI
10.1016/S1388-9842(00)00074-X