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B-type natriuretic peptide and left ventricular dysfunction on exercise echocardiography in patients with chronic

R S Gabriel1, A J Kerr, V Sharma

  • 1Department of Cardiology, Middlemore Hospital, Auckland, New Zealand.

Heart (British Cardiac Society)
|November 3, 2007
PubMed

Insights

In moderate to severe aortic regurgitation (AR), elevated B-type natriuretic peptide (BNP) indicates more severe disease and early left ventricular (LV) dysfunction. Normal BNP levels do not rule out compensatory LV remodeling in AR patients.

Area of Science:

  • Cardiology
  • Biomarkers
  • Echocardiography

Background:

  • Moderate to severe aortic regurgitation (AR) can lead to left ventricular (LV) dysfunction.
  • B-type natriuretic peptide (BNP) is a known marker for heart failure.
  • The role of BNP in predicting LV dysfunction in AR requires further investigation.

Purpose of the Study:

  • To investigate if plasma BNP levels predict LV dysfunction in patients with moderate to severe AR using exercise echocardiography.
  • To assess the relationship between BNP levels and echocardiographic measures of LV function.

Main Methods:

  • A case-control study was conducted with 39 patients with chronic moderate to severe AR and 10 healthy controls.
  • Plasma BNP levels and echocardiographic measures of LV function were assessed at rest and after treadmill exercise.
  • Left ventricular ejection fraction, LV end-systolic volume index, and LV longitudinal strain rate were key echocardiographic parameters.

Main Results:

  • AR patients with normal BNP showed increased LV end-systolic volume index compared to controls.
  • No association was found between resting BNP levels and LV function in AR patients.
  • Increased BNP correlated with more severe AR and was associated with greater LV end-systolic volume index and lower LV longitudinal strain rate after exercise.

Conclusions:

  • Compensatory left ventricular remodeling in moderate to severe AR can occur without elevated plasma BNP.
  • Elevated BNP in AR patients is linked to more severe regurgitation and early signs of LV dysfunction on exercise echocardiography.
Abstract

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