PMID- 19660612
OWN - NLM
STAT- MEDLINE
DCOM- 20090827
LR  - 20090807
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 104
IP  - 4
DP  - 2009 Aug 15
TI  - Relation of N-terminal pro-B-type natriuretic peptide to symptoms, severity, and 
      left ventricular remodeling in patients with organic mitral regurgitation.
PG  - 559-64
LID - 10.1016/j.amjcard.2009.04.023 [doi]
AB  - Natriuretic peptides reflect cardiac stress and may therefore be useful in the 
      management of patients with valvular heart disease. Data regarding these 
      biomarkers in organic mitral regurgitation (MR) are sparse. In this study, 144 
      patients with moderate or severe organic MR were prospectively enrolled in an 
      observational, multicenter study to analyze the relation of N-terminal-pro-B-type 
      natriuretic peptide (NT-pro-BNP) to symptoms, severity of MR, and 
      echocardiographic parameters. NT-pro-BNP levels (median 373 pg/ml, interquartile 
      range 150 to 997) were associated with age, gender, creatinine, New York Heart 
      Association (NYHA) functional class, atrial fibrillation, left ventricular (LV) 
      end-systolic dimension, and the LV ejection fraction. Independent predictors of 
      increased NT-pro-BNP levels were NYHA functional class (p = 0.003), atrial 
      fibrillation (p = 0.005) and LV end-systolic dimension (p = 0.029). MR severity 
      and left atrial dimension were not independently associated with NT-pro-BNP 
      levels. NT-pro-BNP levels increased significantly with NYHA class (p <0.001) but 
      not with MR severity (p = 0.144). NT-pro-BNP levels were significantly higher in 
      symptomatic patients than in asymptomatic patients (582 pg/ml [interquartile 
      range 246-1,360] vs 157 pg/ml [interquartile range 64 to 256], p <0.0001). The 
      area under the receiver-operating characteristic curve to predict symptoms for 
      NT-pro-BNP was 0.80 (95% confidence interval 0.71 to 0.88), which was 
      significantly higher than for all echocardiographic variables (p <0.001 for all). 
      In conclusion, NYHA functional class, atrial fibrillation, and LV end-systolic 
      dimension are independent predictors of increased NT-pro-BNP levels in patients 
      with moderate or severe organic MR. Therefore, NT-pro-BNP may be helpful in the 
      clinical evaluation and management of patients with MR, especially when it is 
      doubtful whether symptoms are related to MR or not.
FAU - Potocki, Mihael
AU  - Potocki M
AD  - Department of Internal Medicine, University Hospital, Basel, Switzerland. 
      potockim@uhbs.ch
FAU - Mair, Johannes
AU  - Mair J
FAU - Weber, Michael
AU  - Weber M
FAU - Hamm, Christian
AU  - Hamm C
FAU - Burkard, Thilo
AU  - Burkard T
FAU - Hiemetzberger, Renate
AU  - Hiemetzberger R
FAU - Peters, Klaus
AU  - Peters K
FAU - Jander, Nikolaus
AU  - Jander N
FAU - Cron, Thomas A
AU  - Cron TA
FAU - Hess, Niklaus
AU  - Hess N
FAU - Hoffmann, Andreas
AU  - Hoffmann A
FAU - Gekeler, Helmut
AU  - Gekeler H
FAU - Gohlke-Barwolf, Christa
AU  - Gohlke-Barwolf C
FAU - Buser, Peter
AU  - Buser P
FAU - Mueller, Christian
AU  - Mueller C
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20090618
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - 0 (Peptide Fragments)
RN  - 0 (pro-brain natriuretic peptide (1-76))
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Aged
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve Insufficiency/*blood/*complications/physiopathology
MH  - Natriuretic Peptide, Brain/*blood
MH  - Peptide Fragments/*blood
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Stroke Volume
MH  - Ventricular Remodeling/*physiology
EDAT- 2009/08/08 09:00
MHDA- 2009/08/28 09:00
CRDT- 2009/08/08 09:00
PHST- 2009/03/01 00:00 [received]
PHST- 2009/04/13 00:00 [revised]
PHST- 2009/04/13 00:00 [accepted]
PHST- 2009/08/08 09:00 [entrez]
PHST- 2009/08/08 09:00 [pubmed]
PHST- 2009/08/28 09:00 [medline]
AID - S0002-9149(09)00927-8 [pii]
AID - 10.1016/j.amjcard.2009.04.023 [doi]
PST - ppublish
SO  - Am J Cardiol. 2009 Aug 15;104(4):559-64. doi: 10.1016/j.amjcard.2009.04.023. Epub 
      2009 Jun 18.