Nt-ProBNP Discriminatory Role Between Symptomatic and Asymptomatic Patients with Severe Valvular Aortic Stenosis

Author:

Antova Emilija1,Petkovska Lidija2,Bosevski Marijan1,Stojkovik Jagoda3,Hadzy-Petrushev Nikola4,Kamkin Andre5,Mladenov Mitko45

Affiliation:

1. Medical Faculty, University Clinic of Cardiology , “Ss. Cyril and Methodius” University , 1000 Skopje , Repubic of Macedonia

2. Medical Faculty, University Clinic of Toxicology , “Ss. Cyril and Methodius” University , 1000 Skopje , Repubic of Macedonia

3. Medical Faculty, University Clinic of Pulmology , “Ss. Cyril and Methodius” University , 1000 Skopje , Repubic of Macedonia

4. Faculty of Natural Sciences and Mathematics, Institute of Biology , “Ss. Cyril and Methodius” University , Skopje , Repubic of Macedonia

5. Department of Fundamental and Applied Physiology , Russian National Research Medical University , Russia

Abstract

Abstract Background: The aim was to evaluate the Nt-proBNP discriminatory role between symptomatic and asymptomatic patients with severe aortic stenosis. Methods: 187 patients with severe valvular aortic stenosis, with normal EF > 50%, were included, 61 asymptomatic and 126 symptomatic. We used clinical, laboratory (Nt-proBNP) and echocardiographic parameters. Endpoints of monitoring (occurrence of event) were: the onset of symptoms in asymptomatic patients and death in both groups. Results: The symptomatic group with severe AS had a significantly higher means of Nt-proBNP, in comparison with the asymptomatic group. Nt-proBNP was a significant predictor for the risk of event occurrence (HR 1.4). In the group of severe AS without CAD (n = 101), the subgroup with Nt-proBNP above the cut-off value, took significantly higher percentage of patients with chest pain, fatigue and syncope. In the group with Nt-proBNP above the cut-off value, we had a significantly higher percentage of patients with severe AS without CAD, compared to those with CAD (n = 142). Nt-proBNP was negatively correlated with AVA and LVEF, whether the positive correlation was expressed for: LVEDd, LVEDs, IVSd, AV_Vmax, AV_MaxGrad, LVM and LA. Patients with Nt-proBNP above the cut-off, had a significantly lower event free survival, compared to patients with Nt-proBNP below the cut-off (n = 187; n = 101). Conclusion: The Nt-proBNP cut-off> 460 pg/ml was confirmed as a useful tool in the determination of event free survival in patients with severe AS. Nt-proBNP not only had relevance in the assessment of the severity of the disease, but also was a significant predictor for the risk of event occurrence.

Publisher

Walter de Gruyter GmbH

Subject

General Medicine

Reference22 articles.

1. 1. Vahanian A, Alfieri O, Andreotti F et al. The Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Guidelines for the management of valvular heart disease (version 2012). European Heart Journal 2012; 33: 2451-2496.10.1093/eurheartj/ehs109

2. 2. Baumgartner H, Falk V, Bax JJ, et al. ESC/EACTS Guidelines for the management of valvular heart disease, European Heart Journal 2017; 38: 2739-279110.1093/eurheartj/ehx391

3. 3. Bonow RO, Carabello BA, Chatterjee K, et al. American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease, J Am Coll Cardiol 2008; 52: 1-142.

4. 4. Schiller NB, Shah PM, Crawford M et al. Recommendations for quantitation of the left ventricle by two-dimensional echocardiography: American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms. J Am Soc Echocardiogr 1989; 2: 358-367.10.1016/S0894-7317(89)80014-8

5. 5. Popescu BA, Andrade MJ, Badano LP, et al. European Association of Echocardiography recommendations for training, competence, and quality improvement in echocardiography. Eur J Echo-cardiogr 2009; 10: 893-905.10.1093/ejechocard/jep151

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