Abstract 14256: The Prognostic Implications of Brain Natriuretic Peptide Levels in Patients with Severe Symptomatic Aortic Stenosis
Background: Brain natriuretic peptide (BNP) is a marker of systolic and diastolic dysfunction and is a strong independent predictor of mortality in patients with heart failure. The correlation between BNP and aortic stenosis (AS) severity and the prognostic value of BNP in severe AS patients is unknown.
Aim: The present study aims to assess the relationship of BNP with AS severity and prognosis.
Methods: The study cohort consisted of 199 high-risk patients with severe AS who were referred to participate in a clinical trial of percoutaneous aortic valve replacement. These patients were divided into tertiles according to BNP level.
Results: There was no significant difference between groups in the baseline characteristics. (Table) The NYHA functional class, STS, logistic EuroSCORE, creatinine, and pulmonary artery systolic pressure were significantly higher in the high-level BNP groups. The ejection fraction, cardiac output, and aortic systolic pressure were significantly lower in the high BNP level groups. There was no significant difference between the groups in aortic valve area. There was no significant correlation between BNP level and aortic valve area (r=-0.06, p=0.55). There was significant correlation was between BNP level and pulmonary artery pressure (r=0.17, p=0.001), creatinine level (r=0.23, p<0.001), ejection fraction (r=-0.41, p <0.001), logistic Euroscore (r= 0.29, p=0.001) and sodium level (r=-0.21, p <0.01). The mortality rates during median follow up of 336±302 days were significantly lower in the low-level BNP groups compared to high-level BNP groups.
Conclusion: High BNP level in high-risk patients with severe AS is significantly associated with mortality. BNP level appears to be significantly associated with congestive heart failure but not AS severity.
- © 2010 by American Heart Association, Inc.