Document Detail

Change of B-Type Natriuretic Peptide After Surgery and Its Association With Rhythm Status in Patients With Chronic Severe Mitral Regurgitation.
MedLine Citation:
PMID:  23218467     Owner:  NLM     Status:  Publisher    
BACKGROUND: B-type natriuretic peptide (BNP) is a useful biomarker of cardiac function in patients with mitral regurgitation (MR). However, the change in BNP in association with rhythm status after corrective surgery has not been studied. METHODS: A total of 101 patients with chronic severe MR undergoing surgery were prospectively enrolled. BNP assays and echocardiographic studies were conducted before and 6 months after surgery. Patients were divided into 3 groups according to pre- and postoperative rhythm (sinus to sinus [SS], n = 61; atrial fibrillation [AF] to sinus [AS], n = 28; AF to AF [AA], n = 12). RESULTS: BNP decreased only in the AS group 6 months after mitral surgery (from 218.0 ± 136.5 to 94.7 ± 85.1 pg/mL; P < 0.001) but not in the SS or AA groups (P for interaction = 0.001). However, changes of echocardiographic parameters after surgery were not different among the 3 groups. In the AA group, postoperative left ventricular (LV) end-diastolic dimension and left atrial volume were higher than the other groups. Significant determinants of BNP were the presence of AF and the higher pulmonary artery systolic pressure preoperatively (β = 0.767 and P = 0.001 for AF; β = 0.022 and P = 0.019 for pulmonary artery systolic pressure), and the lower LV ejection fraction postoperatively (β = -0.030; P = 0.011). CONCLUSIONS: After surgical correction of chronic organic severe MR, BNP decreased only in patients with preoperative AF which was converted to sinus rhythm postoperatively. A reduction in BNP was not observed when rhythm status did not change. BNP activation was associated with the presence of AF and LV systolic dysfunction, suggesting its prognostic value.
In-Chang Hwang; Dae-Hee Kim; Yong-Jin Kim; Kyung-Hee Kim; Seung-Pyo Lee; Hyung-Kwan Kim; Dae-Won Sohn; Byung-Hee Oh; Young-Bae Park
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-3
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  -     ISSN:  1916-7075     ISO Abbreviation:  Can J Cardiol     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea; Cardiovascular Center, Seoul National University Hospital, Seoul, Korea.
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