Brain natriuretic peptide as a marker of left ventricular hypertrophy in patients with aortic stenosis

In aortic stenosis (AS), serum levels of brain natriuretic peptide (BNP) are elevated, but the relation of this elevation to the degree of left ventricular hypertrophy (LVH) remains unclear. The study aim was to assess the relationship between BNP and LVH (expressed as LV mass index, LVMI) and LV wall thickness index (WThI) in a group of patients.

A total of 147 patients with AS (85 men, 62 women; mean age 61 +/- 12 years) each underwent echocardiography and serum BNP analysis. The correlation between serum BNP level and LVH was investigated, with patient gender, age, NYHA class, AS severity and presence of coronary artery disease also being taken into account.

Among AS patients, serum BNP levels ranged from 3 to 2010 pg/ml; mean BNP levels were similar in women and men (213 +/- 302 and 253 +/- 375 pg/ml, respectively). The BNP level also correlated directly with the LVMI (r = 0.55; p <0.0001), WThI (r = 0.26; p <0.001), end-diastolic dimension (r = 0.43; p <0.0001), mean aortic gradient (r = 0.25; p = 0.002), age (r = 0.27; p = 0.001); and correlated inversely with the LV ejection fraction (r = -0.52; p <0.0001). Eccentric LVH was associated with a significantly higher serum BNP level (506 +/- 558 pg/ml) than concentric-type hypertrophy (190 +/- 254 pg/ml; p = 0.002).

The measurement of serum BNP levels is of potential value when monitoring LVH in aortic stenosis patients.