Archives of the Turkish Society of Cardiology
The relationship of high plasma levels of atrial and brain natriuretic peptides with disease severity in mitral valve stenosis [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2006; 34(8): 484-488

The relationship of high plasma levels of atrial and brain natriuretic peptides with disease severity in mitral valve stenosis

Nevzat Uslu, Ahmet L. Orhan, Zekeriya Nurkalem, İlker Avcı, Hasan O. Özer, İbrahim Sarı, Zübeyir Acar, Şevket Görgülü, Mehmet Eren
Siyami Ersek Thoracic And Cardiovascular Surgery Center, Cardiology Department


OBJECTIVES
We aimed to determine plasma levels of atrial (ANP) and brain (BNP) natriuretic peptides in patients with mitral stenosis (MS), and to seek clinical and echocardiographic correlations with these peptides.

STUDY DESIGN
Thirty-eight patients (33 females, 5 males; mean age 44±9 years) with MS and 12 healthy controls (10 females, 2 males; mean age 46±7 years) were examined by echocardiography. All the patients were in sinus rhythm. Venous blood samples were taken to measure ANP and BNP levels.

RESULTS
Compared with controls, patients with MS had significantly higher plasma ANP (6±4 ng/ml vs 45±33 ng/ml) and BNP (12±7.2 pg/ml vs 79±55 pg/ml) levels (p<0.001). Diameters of the left atrium and left atrial volume index were significantly increased (p<0.001), and early (p=0.001) and late (p=0.02) diastolic velocities measured at the lateral annulus of the mitral valve were significantly decreased in the patient group. Systolic velocities showing systolic function of the left ventricle were found similar. Increased ANP and BNP levels showed significant correlations with functional capacity (r=0.43, p=0.007 and r=0.44, p=0.006, respectively), estimated pulmonary artery systolic pressure (r= 0.37, p= 0.022 and r= 0.39, p= 0.019), and left atrial volume index (r=0.48, p=0.003 and r=0.41, p=0.015). Mitral valve area was significantly correlated only with the ANP level (r=-0.37, p=0.022). In multivariate regression analysis, left atrial volume index and estimated pulmonary artery systolic pressure were found to be independent predictors for both BNP (ß=0.32, p=0.040 and ß=0.34, p=0.030, respectively) and ANP (ß=0.40, p=0.010 and ß=0.32, p=0.040) levels.

CONCLUSION
Our data suggest that left atrial volume index and estimated pulmonary artery systolic pressure are strongly correlated with increases in BNP and ANP levels in MS, making BNP and ANP helpful in determining the severity of MS in patients with insufficient echocardiographic data.

Keywords: Biological markers/blood, echocardiography, mitral valve stenosis/ultrasonography, natriuretic peptides//blood

How to cite this article
Nevzat Uslu, Ahmet L. Orhan, Zekeriya Nurkalem, İlker Avcı, Hasan O. Özer, İbrahim Sarı, Zübeyir Acar, Şevket Görgülü, Mehmet Eren. The relationship of high plasma levels of atrial and brain natriuretic peptides with disease severity in mitral valve stenosis. Turk Kardiyol Dern Ars. 2006; 34(8): 484-488

Corresponding Author: Nevzat Uslu, Türkiye
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