[Atrial natriuretic peptide in rheumatic mitral valve disease]

The aim of the study was to analyze atrial natriuretic peptide (ANP) plasma level in patients with rheumatic mitral valve disease in correlation with NYHA functional class and selected hemodynamic parameters based on noninvasive diagnostic procedures. Echocardiographic (2-D, Doppler) and X-ray chest examination were performed to measure left atrium dimension, mitral gradient and relative heart volume (RHV). Control group consisted of 10 healthy subjects. ANP were measured (radioimmunoassay) in 35 patients before valve replacement. Mean values for ANP were significantly elevated in all patients compared to control group (p < 0.001). No significant difference between ANP secretion in pts with sinus rhythm (mean ANP level 25.3 +/- 6.9 pmol/l) and pts with atrial fibrillation (mean ANP level 26.7 +/- 7.6 pmol/l) occurred. Positive correlation between left atrium dimension and ANP level were found (r = 0.964) and also between RHV and ANP level (r = 0.9) and between NYHA class and ANP level (r = 0.63). The conclusion is that ANP secretion is elevated in all patients with heart failure due to mitral valve disease proportional to its stage.