Comparison of Atrial and Brain Natriuretic Peptide for the Assessment of Mitral Stenosis

Sharma, Vishal; Stewart, Ralph; Zeng, Irene; Raffel, Corey; Kerr, Andrew

doi:10.1016/j.hlc.2011.03.112

Cited by 19 publications

(17 citation statements)

References 29 publications

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“…In our study neurohormones did not prove their prognostic value in patients with MS. Of note, despite improvement of clinical status and the positive correlation between the levels of two studied neuropeptides, we did not observe a continuous ANP decrease. That may be a surprise taking into account that previous studies found that ANP level decreased significantly after PBMV and correlated with the parameters of mitral stenosis [36]. It can be speculated whether the large number of patients with atrial fibrillation in this study group compared to patients with heart failure of other origin might have an impact on the prognostic value on ANP.…”

Section: Discussionmentioning

confidence: 80%

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

Mazurkiewicz

Rużyłło

Chmielak

et al. 2017

pwki

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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.

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Section: Discussionmentioning

confidence: 80%

“…So far only Sharma et al have identified BNP as a predictor of treadmill exercise capacity in similar group of patients [36]. To date the prognostic value of neurohormone concentrations was well established only in patients with congestive heart failure of different origin [37–40].…”

Section: Discussionmentioning

confidence: 99%

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

Mazurkiewicz

Rużyłło

Chmielak

et al. 2017

pwki

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“…Sharma et al revealed that both ANP and BNP levels increased in parallel to the severity of disease, ANP and BNP levels correlated with one another, but for reduced exercise capacity, BNP was a more powerful indicator than ANP in MS patients. An interesting finding from this study is that when MS patients with NP levels within the normal range were compared to the control group, it was found that the left atrial area was wider, resting and exercise pulmonary artery pressures were higher and exercise capacity was reduced in patients with MS (265). Accordingly, cardiac remodeling and early dysfunction might develop in MS patients without BNP increase as well.…”

Section: Mitral Stenosismentioning

confidence: 72%

Natriuretic Peptides in Clinical Practice

Çavuşoğlu

Alper²,

Altay³

et al. 2019

Anatol J Cardiol

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Natriuretic peptides (NP) are commonly used diagnostic biomarkers in heart failure (HF). While the American HF guideline strongly recommends NPs as class I indication with the level of evidence A in the diagnosis of both acute and chronic HF (1), the European HF guideline recommends them as class I indicationwith the level of evidence A for acute HF and as class IIa indication with the level of evidence C for chronic HF (2). Similarly, NPs have been proven to be strong biomarkers for prognosis and risk assessment in HF. The American HF guideline recommends NPs as class I indication with the level of evidence A in the assessment of prognosis of both acute and chronic HF (1). Moreover, the American HF guideline recommends NP monitorization as class IIa indication with the level of evidence B for achieving optimal treatment target in chronic HF (1). However, it Natriuretic peptides have long been introduced into clinical practice. These biomarkers have certainly been shown to provide useful information in the diagnosis, prognosis and risk stratification in heart failure and also may have a role in the guidance of heart failure therapy. Although, there are some limitations in using of these markers such as lack of specificity, aging, renal dysfunction or obesity, among the huge number of candidates for heart failure biomarkers, only natriuretic peptides are currently widely used in daily clinical practice in heart failure. Recent heart failure guidelines recognize natriuretic peptides as an essential tool in the new diagnostic and therapeutic algorithms. Furthermore, natriuretic peptides are not only used in the diagnosis or prognosis of heart failure, but also these biomarkers are referred to have some potential role in primary prevention, cardio-oncology, advanced heart failure, assessment of response to cardiac resynchronization therapy, pulmonary arterial hypertension, acute coronary syndromes, atrial fibrillation and valvular heart disease. In this article, natriuretic peptides have been reviewed for their updated information and new recommendations in heart failure and also potential role of these biomarkers in the management of various clinical conditions have been addressed in the form of expert opinion based on the available data in the literature.

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“…Symptomatic status is mainly subjective, and hence a better risk stratification objective tool is required to be implemented in regular follow up of rheumatic MS patients. 5 The safety and success of Balloon Mitral Valvuloplasty (BMV) techniques is mostly dependent on the selection of patients. There are multiple predictors of the outcome, including age, functional class, previous commissurotomy, pre-procedure Mitral Valve (MV) area, valve anatomy, and balloon size used.…”

Section: Introductionmentioning

confidence: 99%

Biomarkers Score for Patients with Mitral Stenosis: A useful conjunction with Wilkins’s Score for Early Intervention

Mahfouz¹,

El-dawei²,

Elawady³

et al. 2015

Heart Res Open J

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Comparison of Atrial and Brain Natriuretic Peptide for the Assessment of Mitral Stenosis

Cited by 19 publications

References 29 publications

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

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

Natriuretic Peptides in Clinical Practice

Biomarkers Score for Patients with Mitral Stenosis: A useful conjunction with Wilkins’s Score for Early Intervention

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