Share this page on LinkedIn
Share This Page on Google+
Share This Page on Twitter
tell someone about this page print this page
You are here: Contents > 2012 > Volume 21 Number 3 May 2012 > AORTIC VALVE DISEASE > Natriuretic Peptides and Long-Term Mortality in Patients with Severe Aortic Stenosis

Natriuretic Peptides and Long-Term Mortality in Patients with Severe Aortic Stenosis

Marcelo Katz, Flavio Tarasoutchi, Antonio Eduardo Pereira Pesaro, Renato D. Lopes, Guilherme Sobreira Spina, Marcelo Luiz Campos Vieira, Max Grinberg

Heart Institute, University of Sao Paulo Medical School, Brazil, Albert Einstein Hospital, Sao Paulo, Brazil, Duke Clinical Research Institute, Duke University Medical Center, Duke Clinical Research Institute, Durham, NC, USA

Background and aim of the study: The natriuretic peptides, brain natriuretic peptide (BNP) and its N-terminal prohormone (NT-proBNP), can be used as diagnostic and prognostic markers for aortic stenosis (AS). However, the association between BNP,
NT-proBNP, and long-term clinical outcomes in patients with severe AS remains uncertain.
Methods: A total of 64 patients with severe AS was prospectively enrolled into the study, and underwent clinical and echocardiographic assessments at baseline. Blood samples were drawn for plasma BNP and NT-proBNP analyses. The primary outcome was death from any cause, through a six-year follow up period. Cox proportional hazards modeling was used to examine the association between natriuretic
peptides and long-term mortality, adjusting for important clinical factors.
Results: During a mean period of 1,520 ± 681 days,
51 patients (80%) were submitted to aortic valve

replacement, and 13 patients (20%) were medically managed without surgical interventions. Mortality rates were 13.7% in the surgical group and 62% in the medically managed group (p <0.001). Patients with higher plasma BNP (>135 pg/ml) and NT-proBNP (>1,150 pg/ml) levels at baseline had a greater risk of long-term mortality (hazard ratio [HR] 3.2, 95% confidence interval [CI] 1.1–9.1; HR 4.3, 95% CI 1.4-13.5, respectively). After adjusting for important covariates, both BNP and NT-proBNP remained independently associated with long-term mortality (HR 2.9, 95%CI 1.5–5.7; HR 1.8, 95%CI 1.1–3.1, respectively).
Conclusion: In patients with severe AS, plasma BNP and NT-proBNP levels were associated with long-term mortality. The use of these biomarkers to guide treatment might represent an interesting approach that deserves further evaluation.

The Journal of Heart Valve Disease 2012;21:331-336

Natriuretic Peptides and Long-Term Mortality in Patients with Severe Aortic Stenosis

Click the above hyperlink to view the article, right click (Ctrl click on a Mac) to open in a new browser window or tab.

Purchase this Article

Please click the button below to purchase this article. Single article purchases are provided at $50.00 per article. Upon clicking the button below, single article user account subscription details are requested and, upon successful payment, a single article user account is created. Single articles are availble in your account for seven days after purchase.