Abstract 15303: Role of BNP and CT Aortic Valve Calcium Score in the Assessment of Severity of Aortic Stenosis
Introduction- Although B-type naturetic peptide (BNP) levels and aortic valve calcium scores (AVC) have been shown to determine prognosis in patients with preserved EF and aortic stenosis (AS), the relative value of each test is not well studied in a prospective group of patients.
Objective- To determine the role of BNP and AVC score in patients with aortic stenosis.
Methods- We prospectively measured both BNP and AVC score by CT scan in 90 patients with preserved EF but no (n= 30), mild (MG 10-25 mmHg; n= 24), moderate (MG 25-40 mmHg; n= 22), or severe (MG >40 mmHg; n= 14) AS who were underwent echocardiographic examination at our institution.
Results- Mean age between the groups (73±11yrs; 73±12yrs; 77±6yrs; 77±10yrs, no vs. mild vs. mod vs. severe AS) was not different (p=0.23). BNP was not different between groups (p=0.1) (Figure, left panel) while AVC score was significantly different between groups (p<0.001) (Figure, right panel). ROC analysis revealed that BNP was not useful in discriminating between severe and non severe AS (AUC 0.64; p=0.11) while AVC score was extremely beneficial (AUC 0.92; p<0.001). AVC score of 1100 had a sensitivity of 93 % and a specificity of 76% in identifying patients with severe AS.After adjusting for age, diastolic function as determined by the ratio of mitral infow velocity to mitral medial annular velocity (E/e'), and creatinine in a logistic regression model, log BNP was not associated with the severity of AS (p=0.61), whereas AVC score was associated with severity of AS (p<0.0001). Log BNP was significantly associated and moderately correlated with diastolic function (r=0.37; p=0.0004).
Conclusions- -1) AVC score is highly correlated with the severity of AS and may be used as a surrogate for the severity of aortic stenosis and as a prognostic factor. On the contrary, BNP appears to be mostly a reflection of diastolic dysfunction rather than the hemodynamic severity of AS and thus may be less useful as a prognostic factor in patients with AS.
- © 2011 by American Heart Association, Inc.