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- Title
Clinical and Echocardiographic Correlates of Plasma B-type Natriuretic Peptide Levels in Patients with Aortic Valve Stenosis and Normal Left Ventricular Ejection Fraction.
- Authors
Maréchaux, Sylvestre; Hattabi, Mehdi; Juthier, Francis; Neicu, Dan Valentin; Richardson, Marjorie; Carpentier, Emilie; Bouabdallaoui, Nadia; Delelis, François; Banfi, Carlo; Breyne, Joke; Jude, Brigitte; Asseman, Philippe; Vincentelli, André; Le Tourneau, Thierry; Graux, Pierre; Pibarot, Philippe; Ennezat, Pierre Vladimir
- Abstract
Background: Several studies suggest that BNP testing may help define the timing of aortic valve surgery in patients with aortic valve stenosis (AVS) prior onset of overt LV systolic dysfunction. The aim of this study was to identify clinical and echocardiographic correlates of plasma BNP levels in a large cohort of patients with AVS and preserved LV ejection fraction. Method and results: One hundred thirty-five consecutive patients were prospectively included in the present study (Mean age 73 ± 13 years old, 66 (49%) male). Eighty-nine patients (66%) had severe AVS (aortic valve area <0.6 cm2/m2 BSA). Plasma BNP levels, clinical and comprehensive Doppler echocardiography evaluation was performed in all patients. Independent clinical correlates of plasma BNP levels (R2= 0.19) were older age (P < 0.0001) and presence of AVS symptoms (P = 0.004). Independent echocardiographic correlates of plasma BNP levels (R2= 0.38) were E/Ea ratio (P = 0.01), LV mass index (P = 0.018), left atrial surface (P < 0.0001) and systolic pulmonary artery pressure (sPAP; P = 0.004). Overall, independent correlates of plasma BNP levels (R2= 0.47) were older age (P = 0.001), known coronary artery disease (P = 0.047), increased LV mass index (P = 0.001), left atrial enlargement (P = 0.002), and increased sPAP (P = 0.003). Conclusions: In patients with AVS and normal LV ejection fraction, plasma BNP predominantly reflects the clinical and echocardiographic consequences of afterload burden imposed on the left ventricle rather than the severity of valve stenosis, per se. (Echocardiography 2011;28:695-702)
- Subjects
AGE distribution; ANALYSIS of variance; AORTIC stenosis; BLOOD pressure; BODY weight; CARDIAC output; COMPUTER software; STATISTICAL correlation; DOPPLER echocardiography; LEFT heart ventricle; HEART beat; LONGITUDINAL method; PEPTIDE hormones; PULMONARY artery; REGRESSION analysis; STATISTICS; DATA analysis
- Publication
Echocardiography, 2011, Vol 28, Issue 7, p695
- ISSN
0742-2822
- Publication type
Article
- DOI
10.1111/j.1540-8175.2011.01418.x