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Plasma N‐terminal pro BNP and cardiotrophin‐1 are elevated in aortic stenosis
Author(s) -
Talwar Suneel,
Downie Paul F.,
Squire Iain B.,
Davies Joan E.,
Barnett David B.,
Ng Leong L.
Publication year - 2001
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/s1388-9842(00)00074-x
Subject(s) - medicine , cardiology , natriuretic peptide , stenosis , heart failure , aortic valve stenosis , brain natriuretic peptide , doppler echocardiography , aortic valve , blood pressure , diastole
Abstract Background: Echocardiography with Doppler examination of the aortic valve provides a very accurate assessment of the transvalvular gradient and is used to monitor progression of aortic stenosis (AS). Plasma brain natriuretic peptide (BNP) has been shown to correlate with end‐systolic wall stress in patients with AS. Aim: We hypothesized that plasma N‐terminal proBNP (NT proBNP) and a newly identified cytokine cardiotrophin‐1 (CT‐1), which has been shown to stimulate BNP production at a transcriptional level are elevated in patients with AS and correlate to the maximum trans‐valvular aortic pressure gradient (TVPG). Method: We compared plasma NT proBNP and CT‐1 in 15 AS patients [five males, mean age 79 years [range 60–94], mean TPVG 39.3 mmHg (20–100)] with 10 controls (five male, mean age 68 years [56–79]). Results are expressed as mean [ranges] and comparisons were by the Mann–Whitney test. Results: NT proBNP levels were elevated in AS patients [252.9 fmol/ml (79.2–541.8)] when compared with the controls (157.2 fmol/ml [104.7–236.9], P < 0.005). Also CT‐1 levels were elevated in AS patients (57.3 fmol/ml [33–86.3] when compared with the controls [28.3 fmol/ml (6.9–48.3), P < 0.0005]. Both NT proBNP and CT‐1 levels were correlated to the TVPG ( r = 0.53 and r = 0.65, P < 0.05 and P = 0.009, respectively). On best subset analysis the strongest correlate with TVPG was CT‐1 ( R 2 = 38%). The addition of NT proBNP did not improve diagnostic accuracy ( R 2 = 39%). Conclusion: These results suggest NT proBNP and CT‐1 levels increase in proportion to the TVPG and could potentially be used to monitor progression of disease non‐invasively. These markers may also be useful to identify the optimum time for surgery in AS.