PMID- 21570253
OWN - NLM
STAT- MEDLINE
DCOM- 20120103
LR  - 20151119
IS  - 1097-6795 (Electronic)
IS  - 0894-7317 (Linking)
VI  - 24
IP  - 9
DP  - 2011 Sep
TI  - Usefulness of plasma B-type natriuretic peptide in the assessment of disease 
      severity and prediction of outcome after aortic valve replacement in patients 
      with severe aortic stenosis.
PG  - 984-91
LID - 10.1016/j.echo.2011.03.012 [doi]
AB  - OBJECTIVE: The diagnostic and prognostic value of plasma B-type natriuretic 
      peptide (BNP) level in isolated aortic stenosis (AS) has not been fully 
      understood. METHODS: BNP level was determined in 109 consecutive patients with 
      isolated severe AS (68.1 +/- 10.6 years; 53 men; transvalvular peak gradient, 87.2 
      +/- 37.0 mm Hg; valve area index, 0.43 +/- 0.14 cm(2)/m(2)) and 12 healthy volunteers 
      in their stable state. They were followed up for 36 months. RESULTS: BNP level 
      increased with New York Heart Association (NYHA) class (75.2 +/- 95.9 pg/mL, 135.0 
      +/- 112.0 pg/mL, 450.6 +/- 366.3 pg/mL, and 1478.9 +/- 941.5 pg/mL for NYHA I, II, III, 
      and IV, respectively). Left ventricular (LV) mass index had the best relationship 
      with BNP (r = 0.73, P < .0001). Aortic valve replacement (AVR) was eventually 
      performed in 95 patients (male = 44, age = 67.8 +/- 9.3 years). Echocardiography 
      was repeated early (n = 88, 13.2 +/- 6.2 day) and late (n = 62, 32 +/- 10 months) 
      after AVR. Preoperative BNP level correlated with LV mass index early (r = 0.74, 
      P < .0001) and late (r = 0.78, P < .0001) after AVR. Patients with higher BNP 
      level had a tendency to show cardiac symptoms (NYHA > I) late after AVR (NYHA I 
      vs. > I = 160.8 +/- 197.9 pg/mL vs. 504.3 +/- 567.3 pg/mL, P < .0001). Preoperative 
      BNP level predicted the occurrence of perioperative complications (P < .0001). 
      During follow-up of the 94 patients (44 +/- 10 months after AVR), 10 were 
      readmitted for major cardiac and cerebrovascular events, including 9 patients 
      with congestive heart failure and 1 patient with ischemic stroke. An event-free 
      survival rate was significantly higher in patients with BNP </= 312 pg/mL than in 
      patients with BNP > 312 pg/mL (log rank, chi(2) = 10.21, P = .001). Multiple 
      logistic regression analysis revealed that BNP > 312 pg/mL was an independent 
      predictor of AVR complication (odds ratio 5.58; confidence interval, 1.82-20.16; 
      P = .002). Furthermore, BNP was the strongest predictor of major adverse cardiac 
      and cerebrovascular events within 36 months after AVR (odds ratio 8.80; 
      confidence interval, 1.83-42.35; P = .006). CONCLUSION: Plasma BNP level reflects 
      the degree of heart failure, is associated with LV structure and function in 
      severe AS, and is an independent predictor of complication and outcome after AVR. 
      BNP level may be useful in risk stratification of patients with AS in conjunction 
      with other clinical and echocardiographic parameters.
CI  - Copyright (c) 2011 American Society of Echocardiography. Published by Mosby, Inc. 
      All rights reserved.
FAU - Iwahashi, Noriaki
AU  - Iwahashi N
AD  - Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
FAU - Nakatani, Satoshi
AU  - Nakatani S
FAU - Umemura, Satoshi
AU  - Umemura S
FAU - Kimura, Kazuo
AU  - Kimura K
FAU - Kitakaze, Masafumi
AU  - Kitakaze M
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20110512
PL  - United States
TA  - J Am Soc Echocardiogr
JT  - Journal of the American Society of Echocardiography : official publication of the 
      American Society of Echocardiography
JID - 8801388
RN  - 0 (Biomarkers)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve Stenosis/*blood/diagnosis/surgery
MH  - Biomarkers/blood
MH  - Echocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - *Heart Valve Prosthesis Implantation
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/*blood
MH  - Prognosis
MH  - Prospective Studies
MH  - Severity of Illness Index
MH  - Time Factors
MH  - Young Adult
EDAT- 2011/05/17 06:00
MHDA- 2012/01/04 06:00
CRDT- 2011/05/17 06:00
PHST- 2010/08/23 00:00 [received]
PHST- 2011/05/17 06:00 [entrez]
PHST- 2011/05/17 06:00 [pubmed]
PHST- 2012/01/04 06:00 [medline]
AID - S0894-7317(11)00206-9 [pii]
AID - 10.1016/j.echo.2011.03.012 [doi]
PST - ppublish
SO  - J Am Soc Echocardiogr. 2011 Sep;24(9):984-91. doi: 10.1016/j.echo.2011.03.012. 
      Epub 2011 May 12.