Utility of Plasma N-Terminal Brain Natriuretic Peptide as a Marker of Functional Capacity in Patients With Chronic Severe Mitral Regurgitation

Prospective Validation of the Prognostic Usefulness of Brain Natriuretic Peptide in Asymptomatic Patients With Chronic Severe Mitral Regurgitation

“…In experimental models, the transition from compensated to decompensated ventricular function increases the synthesis and secretion of BNP (26). Experimental and clinical data reinforce the hypothesis that higher BNP levels in patients with preserved left ventricular function at rest could represent subclinical ventricular dysfunction (26,27). Thus, these data led us to speculate that the elevations of this peptide in asymptomatic patients may indicate the presence of subtle myocardial impairment elicited by longstanding volume overload.…”

Natriuretic Peptides for Risk Stratification of Patients With Valvular Aortic Stenosis

“…Although the discussion of this topic is beyond the scope of this review, natriuretic peptides correlate with the severity of regurgitation, 25,42 LV remodeling and dysfunction, [43][44][45] symptomatic status, 46,47 and mortality 45,48 in mitral regurgitation and aortic regurgitation.…”

Natriuretic Peptides in Common Valvular Heart Disease

“…Similarly, there is no consistent association with right ventricular function, LV diastolic filling parameters, or measures of end-diastolic size (86,90,92,93). Increased LV end-systolic dimensions or volumes are important markers of ventricular decompensation in chronic MR and are associated with BNP and NT-proBNP in most but not all series (86,89,90,93) as are increased pulmonary arterial systolic pressures (86,89,92).…”

“…A number of studies demonstrated a positive relationship between natriuretic peptides and the severity of both organic and functional MR (87)(88)(89)(90), whereas others have shown either no correlation or a relationship only on univariate analysis (86,(91)(92)(93). Findings are summarized in Table 4.…”