ANP and BNP plasma levels in patients with rheumatic mitral stenosis after percutaneous balloon mitral valvuloplasty

Abstract

IntroductionAtrial (ANP) and B-type (BNP) natriuretic peptides are hormones secreted by the heart as a response to volume expansion and pressure overload.AimTo assess the changes of ANP and BNP after percutaneous balloon mitral valvuloplasty (PBMV) and to investigate factors associated with endpoints.Material and methodsThe study included 96 patients (90.7% females, age 51.6 ±12.2 years) with rheumatic mitral valve stenosis (mitral valve area (MVA) 1.18 (1.01–1.33) cm2, mean mitral gradient (MMG) 8.2 (7.1–9.2) mm Hg, NYHA 2.09 (1.9–2.5)). Patients were followed up for 29.1 months for the search of endpoints.ResultsThe PBMV was successful in all cases. After the procedure MVA increased (1.18–1.78 cm2, p < 0.01) and pulmonary capillary wedge pressure (PCWP) decreased (29.8–21.8 mm Hg, p < 0.01). Concentration of ANP significantly rose 30 min after the PBMV (79.2 vs. 134.2 pg/ml, p = 0.012) and dropped significantly after 24 h (134.2 vs. 70.4 pg/ml, p = 0.01). Furthermore, after 36 months concentration of ANP did not differ from the baseline value (p = NS). BNP concentration at day 1 was lower than at baseline (94.5 vs. 80.2 pg/ml, p = 0.032). Moreover, during the follow-up period BNP continued to fall at all time points. In univariate analysis parameters associated with endpoint occurrence were baseline PAP (p = 0.023), baseline PCWP (p = 0.022), baseline NYHA (p = 0.041) and increase in 6-minute walk test (6MWT) (p = 0.043). In multivariate analysis the only factor associated with endpoint occurrence was baseline NYHA (HR = 1.52, 95% CI: –1.3–1.91, p = 0.022).ConclusionsPatients with MS had increased levels of both BNP and ANP. Baseline NYHA class was found to be associated with outcomes after the procedure.

Mean Levels of B-type Natriuretic Peptide (BNP) in Patients with Mitral Stenosis Caused by Rheumatic Heart Disease

“…Due to this factor we have excluded patients with mild mitral stenosis. The findings of our study are also consistent with the previously conducted case control study by the Mazurkiewicz L et al in 2017 [5]. Some of the previously conducted studies have also shown the association between basic demographic characteristics such as age, gender, pulmonary artery systolic pressure, and blood pressure .…”

“…Echocardiography and Doppler examination are essential for the diagnosis and quantification of the severity of the stenosis. Cardiac hormones such as BNP and ANP also play an important role in determining the severity of valvular heart disease particularly when BNP levels are extremely raised the outcome of patients become poor [5,6]. B-Type natriuretic peptide (BNP) is a hormone secreted in response to the volume and pressure overload caused by stretching of the cardiac myocytes.…”

Global historical retrospect and future prospects on biomarkers of heart failure: A bibliometric analysis and science mapping

“…Of these, ANP and BNP are transcribed and mainly produced in cardiac myocytes of the atrium and ventricle respectively [ 61 ]. Both are caused by stretching of the heart muscle caused by stress or volume overload [ 62 ], which is common in HF. In recent years, BNP and N-terminal pro-B-type Natriuretic Peptide (NT-proBNP) have become powerful biomarkers for the diagnosis and prognosis of HF patients, and they have been included in the latest ESC guidelines for the diagnosis of clinical HF [ 63 ].…”

The Effect of Balloon Mitral Valvuplasty on BNP Plasma Level in Mitral Stenosis

“…In response to the overload of pressure and expansion of volume, the heart attempts to secret certain hormones such as Atrial (ANP) and B-type brain natriuretic peptide (BNP) natriuretic peptides (4). Brain natriuretic peptide is used as a prognostic marker for clinical outcomes in patients with heart failure and acute coronary syndrome.…”

“…Numerous studies have reported that BNP levels are decreased immediately after PTMC (3)(4)(5). Therefore, measuring serum levels of BNP may predict the successfulness of PTMC procedure in patients with symptomatic MS, and may function as a reliable marker.…”