PMID- 28216549
OWN - NLM
STAT- MEDLINE
DCOM- 20170502
LR  - 20170502
IS  - 1349-3299 (Electronic)
IS  - 1349-2365 (Linking)
VI  - 58
IP  - 2
DP  - 2017 Apr 6
TI  - Role of Right Ventricular Dysfunction and Diabetes Mellitus in N-terminal 
      pro-B-type Natriuretic Peptide Response of Patients With Severe Mitral 
      Regurgitation and Heart Failure After MitraClip.
PG  - 225-231
LID - 10.1536/ihj.16-255 [doi]
AB  - MitraClip (MC) is an alternative therapeutic option for patients with severe 
      mitral regurgitation (MR) who are at high surgical risk. Most candidates for MC 
      have severe heart failure (HF) with increased N-terminal pro-B-type natriuretic 
      peptide (NT-pro BNP) levels. We sought to clarify the response of NT-pro BNP 
      after MC and to identify the determinants of NT-pro BNP nonresponders. Among 136 
      consecutive patients successfully treated with MC, we excluded 20 patients due to 
      low baseline NT-pro BNP levels and therefore examined 116 patients. NT-pro BNP 
      responders were defined as patients whose NT-pro BNP levels decreased by > 30% at 
      6 months after MC. Mean NT-pro BNP levels significantly decreased from 6,117 
      pg/mL at baseline to 4,143 pg/mL at 6 months after MC (P < 0.001); 61 patients 
      (53%) were responders. Diabetes mellitus (DM) (51% versus 25%; P = 0.003) and 
      atrial fibrillation (67% versus 49%; P = 0.049) were more common in 
      nonresponders. Baseline New York Heart Association (NYHA) class and NT-proBNP 
      levels were higher in responders. Right ventricular systolic dysfunction (RVSD) 
      defined as tricuspid annular plane systolic excursion (TAPSE) < 15 mm was more 
      common in nonresponders (41% versus 18%; P = 0.008). Multivariable logistic 
      regression analysis revealed that DM (odds ratio [OR], 2.966; P = 0.014), RVSD 
      (OR, 3.948; P = 0.006), and baseline NT-proBNP > 5,000 pg/mL (OR, 0.204; P = 
      0.001) were independent determinants of nonresponders. All-cause death tended to 
      be less common in responders to NT-pro BNP (20% versus 31%; P = 0.163). In 
      conclusion, NT-pro BNP levels significantly decreased after MC. DM and RVSD were 
      determinants of NT-pro BNP nonresponse after the MC procedure.
FAU - Kaneko, Hidehiro
AU  - Kaneko H
AD  - Department of Cardiology, Heart Center Brandenburg, Department of Cardiology, 
      Medical School Brandenburg.
FAU - Neuss, Michael
AU  - Neuss M
FAU - Weissenborn, Jens
AU  - Weissenborn J
FAU - Butter, Christian
AU  - Butter C
LA  - eng
PT  - Journal Article
DEP - 20170220
PL  - Japan
TA  - Int Heart J
JT  - International heart journal
JID - 101244240
RN  - 0 (Peptide Fragments)
RN  - 0 (pro-brain natriuretic peptide (1-76))
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Atrial Fibrillation/blood/complications
MH  - Diabetes Complications/blood
MH  - Female
MH  - Heart Failure/*blood/etiology
MH  - *Heart Valve Prosthesis Implantation
MH  - Humans
MH  - Male
MH  - Mitral Valve Insufficiency/*blood/*complications/surgery
MH  - Natriuretic Peptide, Brain/*blood
MH  - Peptide Fragments/*blood
MH  - Ventricular Dysfunction, Right/blood/complications
EDAT- 2017/02/22 06:00
MHDA- 2017/05/04 06:00
CRDT- 2017/02/21 06:00
PHST- 2017/02/22 06:00 [pubmed]
PHST- 2017/05/04 06:00 [medline]
PHST- 2017/02/21 06:00 [entrez]
AID - 10.1536/ihj.16-255 [doi]
PST - ppublish
SO  - Int Heart J. 2017 Apr 6;58(2):225-231. doi: 10.1536/ihj.16-255. Epub 2017 Feb 20.