Prognostic implications of N-terminal pro-B-type natriuretic peptide in patients with normal left ventricular ejection fraction undergoing transcatheter aortic valve implantation.
Aged
Aortic Valve Stenosis
/ diagnosis
Biomarkers
/ blood
Echocardiography
/ methods
Female
Germany
Humans
Kaplan-Meier Estimate
Male
Natriuretic Peptide, Brain
/ blood
Outcome Assessment, Health Care
Peptide Fragments
/ blood
Predictive Value of Tests
Prognosis
Reproducibility of Results
Risk Assessment
/ methods
Stroke Volume
Transcatheter Aortic Valve Replacement
/ adverse effects
Ventricular Function, Left
Aortic stenosis
Biomarkers
Risk stratification
Transcatheter aortic valve implantation
Journal
International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291
Informations de publication
Date de publication:
15 02 2020
15 02 2020
Historique:
received:
15
05
2019
revised:
16
09
2019
accepted:
11
11
2019
pubmed:
24
11
2019
medline:
15
12
2020
entrez:
24
11
2019
Statut:
ppublish
Résumé
Biomarkers may significantly improve risk stratification algorithms for patients undergoing transcatheter aortic valve implantation (TAVI). While N-terminal pro-B-type natriuretic peptide (NT-proBNP) is established as a biomarker in the context of heart failure, its prognostic implications in patients with normal left ventricular ejection fraction (LVEF) undergoing TAVI are unclear. A total of 504 TAVI patients with normal LVEF were analyzed. Based on preprocedural NT-proBNP levels, patients were stratified into two groups comparing the upper quartile ("Q4", n = 126) with the lower three quartiles ("Q1-3", n = 378). The primary outcome of our study was survival. The "Q4" group included more men (46.8% vs. 34.9%, p = 0.017), had higher rates of atrial fibrillation (55.6% vs. 28.3%, p < 0.001) and showed features of more advanced aortic stenosis (mean pressure gradient 49 mmHg vs. 40 mmHg, aortic valve area 0.6 cm NT-proBNP is associated with survival in TAVI patients with normal LVEF. In this patient group, preprocedural NT-proBNP levels do not only correlate with aortic stenosis, but reflect advanced cardiovascular dysfunction, including HFpEF, that might not be completely reversible after TAVI.
Sections du résumé
BACKGROUND
Biomarkers may significantly improve risk stratification algorithms for patients undergoing transcatheter aortic valve implantation (TAVI). While N-terminal pro-B-type natriuretic peptide (NT-proBNP) is established as a biomarker in the context of heart failure, its prognostic implications in patients with normal left ventricular ejection fraction (LVEF) undergoing TAVI are unclear.
METHODS
A total of 504 TAVI patients with normal LVEF were analyzed. Based on preprocedural NT-proBNP levels, patients were stratified into two groups comparing the upper quartile ("Q4", n = 126) with the lower three quartiles ("Q1-3", n = 378). The primary outcome of our study was survival.
RESULTS
The "Q4" group included more men (46.8% vs. 34.9%, p = 0.017), had higher rates of atrial fibrillation (55.6% vs. 28.3%, p < 0.001) and showed features of more advanced aortic stenosis (mean pressure gradient 49 mmHg vs. 40 mmHg, aortic valve area 0.6 cm
CONCLUSIONS
NT-proBNP is associated with survival in TAVI patients with normal LVEF. In this patient group, preprocedural NT-proBNP levels do not only correlate with aortic stenosis, but reflect advanced cardiovascular dysfunction, including HFpEF, that might not be completely reversible after TAVI.
Identifiants
pubmed: 31757644
pii: S0167-5273(19)32508-2
doi: 10.1016/j.ijcard.2019.11.101
pii:
doi:
Substances chimiques
Biomarkers
0
Peptide Fragments
0
pro-brain natriuretic peptide (1-76)
0
Natriuretic Peptide, Brain
114471-18-0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
195-199Informations de copyright
Copyright © 2019. Published by Elsevier B.V.