| Elevated B-type natriuretic peptide despite normal left ventricular function on rest and exercise stress echocardiography in mitral regurgitation. | |
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MedLine Citation:
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PMID: 18202251 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: To determine whether elevated B-type natriuretic peptide (BNP) predicts left ventricular (LV) contractile dysfunction on exercise stress echocardiography in patients with severe mitral regurgitation (MR). METHODS AND RESULTS: Thirty three patients with moderate-to-severe or severe MR, a LV ejection fraction > or =60% and New York Heart Association Class I or II symptoms, and 12 controls underwent resting and exercise stress echocardiography. In 20 MR patients, BNP was within the normal range (mean +/- SD, 7.7 +/- 2.7 pmol/L), and in 13 MR patients, BNP was >12 pmol/L (19.6 +/- 7.6 pmol/L). LV end-systolic volume index after exercise was lower in controls than patients with MR (P < 0.0001), but similar in MR patients with normal and elevated BNP, respectively (controls 8.5 +/- 3.9, MR 20 +/- 7 vs. 20 +/- 9 cm(2)/m(2), P > 0.05). However, pulmonary artery systolic pressure (PAP) after exercise was higher in MR with high BNP (70 +/- 20 vs. 48 +/- 11 mmHg, <0.0001) and controls (38+/-11 mmHg). A two-fold increase in plasma BNP was associated with an average increase in resting PAP of 7.6 (95% CI 2.9, 12.2) mmHg, an increase in post-exercise PAP of 14.4 (95% CI 9.0, 19.9) mmHg and increase in left atrial area index of 2.1 (95% CI 0.5, 3.8) cm(2)/m(2). However, there was no significant association between the plasma level of BNP and any rest or post-exercise measure of LV systolic function (r < 0.25, P > 0.05 for all). CONCLUSION: The plasma level of BNP may be within the normal range in patients with moderate-to-severe or severe MR despite significant increases in LV end-systolic volume. Increase in BNP is associated with pulmonary artery hypertension on exercise and left atrial enlargement even when LV systolic function on exercise stress echocardiography is normal. |
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Authors:
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Andrew J Kerr; O Christopher Raffel; Gillian A Whalley; Irene Zeng; Ralph A Stewart |
Publication Detail:
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Type: Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't Date: 2008-01-17 |
Journal Detail:
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Title: European heart journal Volume: 29 ISSN: 0195-668X ISO Abbreviation: Eur. Heart J. Publication Date: 2008 Feb |
Date Detail:
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Created Date: 2008-02-04 Completed Date: 2008-06-19 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: England |
Other Details:
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Languages: eng Pagination: 363-70 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Middlemore Hospital, Hospital Road, Private Bag 93311, Otahuhu, Auckland, New Zealand. andrewkerr@middlemore.co.nz |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Case-Control Studies Echocardiography, Stress Female Humans Hypertension, Pulmonary / etiology Male Middle Aged Mitral Valve Insufficiency / blood*, ultrasonography Natriuretic Peptide, Brain / blood* Predictive Value of Tests Stroke Volume Ventricular Dysfunction, Left / blood, diagnosis* Ventricular Function, Left / physiology |
| Chemical | |
Reg. No./Substance:
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114471-18-0/Natriuretic Peptide, Brain |
| Comments/Corrections | |
Comment In:
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Eur Heart J. 2008 Feb;29(3):290-2
[PMID:
18202250
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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