BNP in mitral valve restrictive annuloplasty for ischemic mitral regurgitation

• Published in: International journal of cardiology 2009-09, Vol.137 (1), p.57-60
• Main Authors: Paparella, Domenico, Malvindi, Pietro Giorgio, Romito, Roberta, Iacoviello, Massimo, Visicchio, Giuseppe, Di Serio, Francesca, Favale, Stefano, de Luca Tupputi Schinosa, Luigi
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Brain natriuretic peptide; Cardiology. Vascular system; Cardiovascular; Congestive heart failure; Coronary disease; Coronary heart disease; Endocardial and cardiac valvular diseases; Female; Follow-Up Studies; Functional mitral regurgitation; Heart; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Humans; Male; Medical sciences; Middle Aged; Mitral Valve Insufficiency - blood; Mitral Valve Insufficiency - surgery; Myocardial infarction; Myocardial Ischemia - blood; Myocardial Ischemia - surgery; Myocarditis. Cardiomyopathies; Natriuretic Peptide, Brain - blood; Valve disease
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2008.04.090

Abstract Restrictive annuloplasty with undersized mitral rings is used to correct functional mitral regurgitation (MR) in patients with ischemic left ventricular dysfunction. Seventeen patients with severe coronary artery disease, previous myocardial infarction, moderate/severe functional MR and heart failure symptoms were prospectively evaluated. All patients received CABG associated with restrictive annuloplasty. Preoperatively and 6 months after the operation, clinical evaluation, echocardiography and blood sampling for BNP measurement were performed. Operative mortality occurred in 1 patient. MR degree decreased from 3.8 ± 0.3 to 1.0 ± 0.7 ( p < 0.01), LVEF increased from 36 ± 11% to 43 ± 8% ( p < 0.05), left ventricular end diastolic diameters changed from 54.7 ± 5.2 mm to 51.5 ± 5.8 mm ( p = 0.51). NYHA class improved from 2.94 ± 1.02 to 1.21 ± 0.42 ( p < 0.01). Mean plasma BNP levels decreased from 471 ± 248 pmol/l to 55.6 ± 52.8 pmol/l ( p < 0.05). Restrictive mitral annuloplasty is a safe procedure to be associated to CABG operation. We demonstrated mid-term reduction of BNP plasma values after MR correction thus suggesting the effectiveness of surgical treatment in modifying natural history of the disease.