The relationship between severity of mitral valvular stenosis and the level of serum brain natriuretic peptide

Abstract

Objectives: Although there have been a considerable number of reports about BNP levels in patients with mitral stenosis (MS), the relationship between the brain natri­uretic peptid (BNP) level and the severity of MS is not investigated extensively in patients with sinus rhythm. In this study we aimed to evaluate plasma BNP levels in pa­tients with MS and to determine the relation of BNP levels with the anatomic and physiological severity of MS. Materials and methods: Ninety six patients with isolated rheumatic MS and 40 healthy control subjects (group 1) constituted the study population. The patients with MS were classified as those with mild MS (45 patients, group 2), moderate MS (31 patients, group 3) and severe MS (20 patients, group 4). All subjects underwent a detailed echocardiography and venous blood was drawn for BNP levels. Results: Patients with MS had significantly higher BNP levels than control subjects. In addition, the analysis with respect of the severity of MS showed that BNP levels in­creased significantly from group 1 through to group 4. In correlation analysis, while there was a good correlation between BNP levels with planimetric mitral valve area and pulmonary artery pressure, there was moderate correla­tion between BNP levels with left atrial diameter, mean and maximum gradients. Conclusion: We demonstrated that plasma BNP lev­els were correlated with echocardiographic parameters showing the severity of the MS. Natriuretic peptides might be useful in the clinical and echocardiographic evaluation of MS patients as an indicator of disease severity.

Keywords

• Mitral stenosis, brain ntiruretic peptide, echocardiography

Mitral kapak darlığının ciddiyeti ile beyin natriüretik peptid serum düzeyi arasındaki ilişki

Abstract

Amaç: Mitral darlığı (MD) olan hastalarda beyin natriü­retik peptid (BNP) düzeylerini değerlendiren pek çok çalışma olmakla birlikte, sinüs ritmindeki hastalarda MD ciddiyeti ile BNP arasındaki ilişki ayrıntılı olarak incelen­memiştir. Bu çalışmadaki amacımız; romatizmal MD olgu­larında serum BNP düzeylerini saptamak ve BNP düzey­lerinin MD\'nin anatomik ve fizyolojik ciddiyeti ile ilişkisini belirlemektir. Gereç ve yöntem: Çalışmaya 96 izole romatizmal MD olan hasta ve 40 kontrol grubu (grup 1) alınmıştır. Ro­matizmal MD\'li hastaların 45\'inde hafif (grup 2), 31\'inde orta derece (grup 3) ve 20\'sinde ciddi (grup 4) MD vardı. Bu hastalara ayrıntılı ekokardiyografi yapıldı ve BNP için kan alındı. Bulgular: BNP düzeyleri için kontrol grubu ve MD arasın­da yapılan analizde, MD grubunun kontrol grubuna göre anlamlı derecede daha yüksek BNP düzeylerine sahip ol­duğu izlendi. Ayrıca MD alt gruplarında yapılan analizde BNP değerleri grup 1\'den grup 4\'e doğru anlamlı olarak artmıştır. Korelasyon analizinde BNP değerleri ile mitral kapak alanı ve sistolik pulmoner arter basıncı arasında iyi derecede ilişki mevcutken; ortalama ve maksimum gradi­yentler ve sol atrium çapı ile orta derecede ilişki izlendi. Sonuç: İzole MD olgularında serum BNP düzeyleri has­talığın ciddiyetini gösteren ekokardiyografi parametreleri ile ilişkilidir. Natriüretik peptitler sinüs ritmindeki bu hasta grubunda hastalığın ciddiyetinin bir belirteci olarak klinik ve ekokardiyografik değerlendirmeye ilave katkı sağlaya­bilir.

Keywords

• Mitral darlığı, Beyin natriüretik peptit, ekokardiyografi

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