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Utility of NT-pro-BNP in patients undergoing transapical aortic valve replacement
Roman Pfister1, Thorsten Wahlers, Frank M Baer
1Department of Internal Medicine III, Herzzentrum, University of Cologne, Kerpenerstr. 62, 50937, Cologne, Germany. roman.pfister@uk-koeln.de
Background:
Transapical aortic valve replacement (TAVR) is increasingly being applied in conventionally inoperable patients with aortic stenosis. The utility of the cardiac marker NT-pro-BNP has yet not been assessed in this setting.
Methods:
NT-pro-BNP was assessed preoperatively, postoperatively (day 1, 3, 5 and 8) and 2 months after the intervention in 31 consecutive patients (13 men, 18 women; median age 84) undergoing TAVR and the association with baseline characteristics and outcome was analysed.
Results:
Baseline NT-pro-BNP was associated with baseline creatinine, left-ventricular mass index and NYHA class and predicted regression of LV-mass after 2 months. There was no correlation of NT-pro-BNP with measures of the aortic valve function before or after replacement. The increase of NT-pro-BNP 3 days after TAVR was inversely associated with a functional improvement of >or=1 NYHA class at 2 months. Baseline NT-pro-BNP was not associated with 2-month mortality and major adverse events (death/neurological deficit), whereas the postoperative increase of NT-pro-BNP after TAVR showed a slightly significant inverse and the EuroSCORE a significant correlation.
Conclusions:
In multimorbid patients undergoing TAVR, NT-pro-BNP independently predicted regression of LV-mass after 2 months and early decrease of NT-pro-BNP postoperatively indicated improvement of functional capacity at 2 months. There was no association of NT-pro-BNP with 2-month mortality.
