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Clinical and Echocardiographic Correlates of Plasma B‐type Natriuretic Peptide Levels in Patients with Aortic Valve Stenosis and Normal Left Ventricular Ejection Fraction
Author(s) -
Maréchaux Sylvestre,
Hattabi Mehdi,
Juthier Francis,
Neicu Dan Valentin,
Richardson Marjorie,
Carpentier Emilie,
Bouabdallaoui Nadia,
Delelis François,
Banfi Carlo,
Breyne Joke,
Jude Brigitte,
Asseman Philippe,
Vincentelli André,
Le Tourneau Thierry,
Graux Pierre,
Pibarot Philippe,
Ennezat Pierre Vladimir
Publication year - 2011
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/j.1540-8175.2011.01418.x
Subject(s) - medicine , cardiology , ejection fraction , afterload , ventricle , body surface area , aortic valve stenosis , pulmonary artery , stenosis , heart failure , natriuretic peptide , aortic valve , doppler echocardiography , blood pressure , diastole
Background: Several studies suggest that BNP testing may help define the timing of aortic valve surgery in patients with aortic valve stenosis (AVS) prior onset of overt LV systolic dysfunction. The aim of this study was to identify clinical and echocardiographic correlates of plasma BNP levels in a large cohort of patients with AVS and preserved LV ejection fraction. Method and results: One hundred thirty‐five consecutive patients were prospectively included in the present study (Mean age 73 ± 13 years old, 66 (49%) male). Eighty‐nine patients (66%) had severe AVS (aortic valve area <0.6 cm 2 /m 2 BSA). Plasma BNP levels, clinical and comprehensive Doppler echocardiography evaluation was performed in all patients. Independent clinical correlates of plasma BNP levels (R 2 = 0.19) were older age (P < 0.0001) and presence of AVS symptoms (P = 0.004). Independent echocardiographic correlates of plasma BNP levels (R 2 = 0.38) were E/Ea ratio (P = 0.01), LV mass index (P = 0.018), left atrial surface (P < 0.0001) and systolic pulmonary artery pressure (sPAP; P = 0.004). Overall, independent correlates of plasma BNP levels (R 2 = 0.47) were older age (P = 0.001), known coronary artery disease (P = 0.047), increased LV mass index (P = 0.001), left atrial enlargement (P = 0.002), and increased sPAP (P = 0.003). Conclusions: In patients with AVS and normal LV ejection fraction, plasma BNP predominantly reflects the clinical and echocardiographic consequences of afterload burden imposed on the left ventricle rather than the severity of valve stenosis, per se. (Echocardiography 2011;28:695‐702)