PMID- 35543340
OWN - NLM
STAT- MEDLINE
DCOM- 20220719
LR  - 20221103
IS  - 2055-5822 (Electronic)
IS  - 2055-5822 (Linking)
VI  - 9
IP  - 4
DP  - 2022 Aug
TI  - Prognostic relevance of B-type natriuretic peptide in patients with moderate 
      mixed aortic valve disease.
PG  - 2474-2483
LID - 10.1002/ehf2.13946 [doi]
AB  - AIMS: Data on B-type natriuretic peptide (BNP) levels and adverse outcomes in 
      patients with moderate mixed aortic valve disease (MAVD), defined as moderate 
      aortic stenosis (AS) and regurgitation (AR), are scarce. Therefore, this study 
      investigated the impact of BNP on the clinical outcomes in such patients. METHODS 
      AND RESULTS: Clinical data from 81 patients (mean age, 74.1 +/- 6.8 years; 50.6%, 
      men) treated for moderate MAVD and left ventricular ejection fraction 
      (LVEF) >/= 50% during 2010-2018 were retrospectively analysed. Specific 
      echocardiographic data of the study patients were LVEF of 57.8 +/- 5.0%, aortic 
      valve index of 0.64 +/- 0.04 cm(2) /m(2) , peak aortic valve velocity of 
      3.38 +/- 0.29 m/s, and AR vena contracta width of 4.2 +/- 0.7 mm. The median BNP 
      level was 61.4 pg/mL (interquartile range, 29.7-109.9). The primary endpoint was 
      a composite of all-cause death, heart failure hospitalization, and aortic valve 
      replacement, and its cumulative incidence at 5 years was 57.7%. Multivariable 
      analysis revealed that age (hazard ratio, 1.079; 95% confidence interval, 
      1.028-1.133; P = 0.002) and BNP levels (hazard ratio, 1.028; 95% confidence 
      interval, 1.003-1.053; P = 0.027) were significantly related to the endpoint; 
      specifically, BNP > 61.4 pg/mL had significantly higher incidence rates of the 
      endpoint than those with a BNP </= 61.4 pg/mL (70.3% vs. 45.5% at 5 years; 
      P = 0.018). Compared with patients with BNP </= 61.4 pg/mL, those with 
      BNP > 61.4 pg/mL had significantly worse left ventricular global longitudinal 
      strain (-17.1 +/- 3.6% vs. -18.7 +/- 2.6%; P = 0.029), along with higher left 
      ventricular mass index (116.9 +/- 27.8 g/m(2) vs. 103.5 +/- 19.7 g/m(2) ; P = 0.014), 
      relative wall thickness (0.45 +/- 0.07 vs. 0.42 +/- 0.05; P = 0.022), left atrial 
      volume index (46.0 +/- 28.4 mL/m(2) vs. 31.4 +/- 10.3 mL/m(2) ; P = 0.003), pulmonary 
      artery systolic pressure (32.6 +/- 9.7 mmHg vs. 28.2 +/- 4.7 mmHg; P = 0.011), and 
      prevalence of moderate or greater tricuspid regurgitation (15.0% vs. 0.0%; 
      P = 0.012). CONCLUSIONS: Patients with moderate MAVD are at higher risk of 
      unfavourable clinical outcomes, and age and BNP are independently related to the 
      occurrence of adverse events. High BNP levels may reflect extravalvular cardiac 
      damage in patients with moderate MAVD.
CI  - (c) 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on 
      behalf of European Society of Cardiology.
FAU - Onishi, Hirokazu
AU  - Onishi H
AUID- ORCID: 0000-0001-6250-3891
AD  - Department of Cardiology, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 
      270-2232, Japan.
AD  - Division of Cardiology, Department of Internal Medicine, St. Marianna University 
      School of Medicine, Kanagawa, Japan.
FAU - Naganuma, Toru
AU  - Naganuma T
AD  - Department of Cardiology, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 
      270-2232, Japan.
FAU - Izumo, Masaki
AU  - Izumo M
AD  - Division of Cardiology, Department of Internal Medicine, St. Marianna University 
      School of Medicine, Kanagawa, Japan.
FAU - Ouchi, Toru
AU  - Ouchi T
AD  - Department of Cardiology, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 
      270-2232, Japan.
FAU - Yuki, Haruhito
AU  - Yuki H
AD  - Department of Cardiology, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 
      270-2232, Japan.
FAU - Mitomo, Satoru
AU  - Mitomo S
AD  - Department of Cardiology, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 
      270-2232, Japan.
FAU - Nakamura, Sunao
AU  - Nakamura S
AD  - Department of Cardiology, New Tokyo Hospital, 1271 Wanagaya, Matsudo, Chiba, 
      270-2232, Japan.
LA  - eng
PT  - Journal Article
DEP - 20220511
PL  - England
TA  - ESC Heart Fail
JT  - ESC heart failure
JID - 101669191
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - *Aortic Valve Stenosis/diagnosis/surgery
MH  - Female
MH  - Humans
MH  - Male
MH  - *Natriuretic Peptide, Brain
MH  - Prognosis
MH  - Retrospective Studies
MH  - Stroke Volume
MH  - Ventricular Function, Left
PMC - PMC9288736
OTO - NOTNLM
OT  - Aortic regurgitation
OT  - Aortic stenosis
OT  - Aortic valve replacement
OT  - B-type natriuretic peptide
OT  - Mixed aortic valve disease
COIS- The authors have no conflicts of interest to declare.
EDAT- 2022/05/12 06:00
MHDA- 2022/07/20 06:00
PMCR- 2022/05/11
CRDT- 2022/05/11 06:54
PHST- 2022/03/29 00:00 [revised]
PHST- 2022/01/04 00:00 [received]
PHST- 2022/04/06 00:00 [accepted]
PHST- 2022/05/12 06:00 [pubmed]
PHST- 2022/07/20 06:00 [medline]
PHST- 2022/05/11 06:54 [entrez]
PHST- 2022/05/11 00:00 [pmc-release]
AID - EHF213946 [pii]
AID - 10.1002/ehf2.13946 [doi]
PST - ppublish
SO  - ESC Heart Fail. 2022 Aug;9(4):2474-2483. doi: 10.1002/ehf2.13946. Epub 2022 May 
      11.