| Study of Plasma Levels of Brain
Natriuretic Peptide (BNP) in the Late Phase after Aortic Valve
Replacement |
(Department of Thoracic and Cardiovascular Surgery,
Mie University School of Medicine, Mie, Japan)
| Kazuya Fujinaga |
Koji Onoda |
Shinji Kanemitsu |
| Shin Takabayashi |
Lu Jun |
Akira Shimamoto |
| Takatsugu Shimono |
Kuniyoshi Tanaka |
Hideto Shimpo |
| Isao Yada |
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| This study was designed to assess
the correlation of brain natriuretic peptide (BNP) levels with
cardiac function and to determine the usefulness of BNP as a
prognostic marker in patients undergoing cardiac valvular surgery.
We measured plasma levels of BNP in 53 patients who had undergone
aortic valve replacement (AVR) or aortic and mitral valve replacement
(DVR) more than 1year earlier. These cases were divided into
the aortic stenosis (AS) group and an aortic regurgitation (AR)
group. Fifty-two patients were in NYHA class I, and 43 (82.7%)
of them had plasma levels of BNP above the normal range. There
were significant correlations between the plasma levels of BNP
and ejection fraction (EF) in both the AS and AR groups (r＝－0.460,p＜0.05;
r＝－0.529,p＜0.01). In the AR group, BNP showed significant
correlations with LVMI and LVDd (r＝－0.469,p＜0.05; r＝0.680,p＜0.0001),
whereas, in the AS group, BNP showed no significant correlation
with these factors. The most remarkable finding was the development
of heart failure in 3 patients whose plasma levels of BNP were
over 80pg/ml, despite remaining in NYHA I during follow-up. We
concluded that plasma levels of BNP in a late phase after AVR
or DVR can be an excellent biochemical marker for predicting
of heart failure and overall prognosis. Jpn. J. Cardiovasc. Surg.
29: 320-325 (2000) |
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