B-type natriuretic peptide in low-flow, low-gradient aortic stenosis : Relationship to hemodynamics and clinical outcome: Results from the multicenter truly or pseudo-severe aortic stenosis (TOPAS) study

The prognostic value of B-type natriuretic peptide (BNP) is unknown in low-flow, low-gradient aortic stenosis (AS). We sought to evaluate the relationship between AS and rest, stress hemodynamics, and clinical outcome. BNP was measured in 69 patients with low-flow AS (indexed effective orifice area...

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Published in:Circulation (New York, N.Y.) N.Y.), 2007-06, Vol.115 (22), p.2848-2855
Main Authors: BERGLER-KLEIN, Jutta, MUNDIGLER, Gerald, WALTER-PUBLIG, Nicole, RADER, Florian, BAUMGARTNER, Helmut, PIBAROT, Philippe, BURWASH, Ian G, DUMESNIL, Jean G, BLAIS, Claudia, FUCHS, Christina, MOHTY, Dania, BEANLANDS, Rob S, HACHICHA, Zeineb
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Aortic Valve Stenosis - classification
Aortic Valve Stenosis - complications
Aortic Valve Stenosis - drug therapy
Aortic Valve Stenosis - physiopathology
Biological and medical sciences
Blood and lymphatic vessels
Blood Pressure
Blood. Blood coagulation. Reticuloendothelial system
Cardiac Output
Cardiology. Vascular system
Cardiovascular Abnormalities - epidemiology
Child
Diseases of the aorta
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Heart Rate
Humans
Male
Medical sciences
Middle Aged
Natriuretic Agents - therapeutic use
Natriuretic Peptide, Brain - therapeutic use
Pharmacology. Drug treatments
Ventricular Function, Left
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Summary:The prognostic value of B-type natriuretic peptide (BNP) is unknown in low-flow, low-gradient aortic stenosis (AS). We sought to evaluate the relationship between AS and rest, stress hemodynamics, and clinical outcome. BNP was measured in 69 patients with low-flow AS (indexed effective orifice area < 0.6 cm2/m2, mean gradient < or = 40 mm Hg, left ventricular ejection fraction < or = 40%). All patients underwent dobutamine stress echocardiography and were classified as truly severe or pseudosevere AS by their projected effective orifice area at normal flow rate of 250 mL/s (effective orifice area < or = 1.0 cm2 or > 1.0 cm2). BNP was inversely related to ejection fraction at rest (Spearman correlation coefficient r(s)=-0.59, P
ISSN:0009-7322
1524-4539
DOI:10.1161/CIRCULATIONAHA.106.654210