Christine Henri1, Raluca Dulgheru2, Julien Magne2, Luis Caballero2, Saloua Laaraibi2, Laurent Davin2, Seisyou Kou2, Damien Voilliot2, Alain Nchimi2, Cécile Oury3, Luc A Pierard4, Patrizio Lancellotti5. 1. Departments of Cardiology and Radiology, University of Liège, Groupe Interdisciplinaire de Génoprotéomique Appilquée Cardiovascular Sciences, Heart Valve Clinic, Centre Hospitalier Universitaire Sart Tilman, Liège, Belgium; Division of Non Invasive Cardiology, Department of Medicine, University of Montreal, Montreal Heart Institute, Montréal, Canada. 2. Departments of Cardiology and Radiology, University of Liège, Groupe Interdisciplinaire de Génoprotéomique Appilquée Cardiovascular Sciences, Heart Valve Clinic, Centre Hospitalier Universitaire Sart Tilman, Liège, Belgium. 3. Human Genetics Unit, Laboratory of Thrombosis and Hemostasis, University of Liège, Groupe Interdisciplinaire de Génoprotéomique Appilquée Cardiovascular Sciences, Liège, Belgium. 4. Departments of Cardiology and Radiology, University of Liège, Groupe Interdisciplinaire de Génoprotéomique Appilquée Cardiovascular Sciences, Heart Valve Clinic, Centre Hospitalier Universitaire Sart Tilman, Liège, Belgium. Electronic address: lpierard@chu.ulg.ac.be. 5. Departments of Cardiology and Radiology, University of Liège, Groupe Interdisciplinaire de Génoprotéomique Appilquée Cardiovascular Sciences, Heart Valve Clinic, Centre Hospitalier Universitaire Sart Tilman, Liège, Belgium; Gruppo Villa Maria Care and Research, E.S. Health Science Foundation, Lugo, RA, Italy. Electronic address: plancellotti@chu.ulg.ac.be.
Abstract
BACKGROUND: The aim of this study was to determine the impact on the outcome of serial B-type natriuretic peptide (BNP) changes during follow-up in asymptomatic patients with ≥ moderate aortic stenosis (AS) and preserved left ventricular ejection fraction. METHODS: We prospectively screened 69 patients who underwent comprehensive transthoracic echocardiography, BNP level measurement at baseline and after every 6 or 12 months. Annualized BNP changes were calculated as the difference between the last and baseline BNP measurements divided by the duration of follow-up. The primary endpoint was the occurrence of symptoms, aortic valve replacement, or cardiovascular death. RESULTS: During a follow-up of 30 ± 19 months, 43 patients experienced a cardiac event. These patients were significantly older (73 ± 9 vs 65 ± 16 years; P = 0.010), had more often dyslipidemia (79% vs 42%; P = 0.038), more severe AS (peak velocity: 3.9 ± 0.6 vs 3.5 ± 0.6 m/s; P = 0.002), larger indexed left atrial area (10.2 ± 2.5 vs 8.7 ± 1.9 cm(2)/m(2); P = 0.006), and a higher increase in annualized BNP (+90 ± 155 vs +7 ± 49 pg/mL/y; P = 0.010). Patients with higher annualized BNP changes (> 20 pg/mL/y) had a significantly lower cardiac event-free survival (1 year: 63 ± 8% vs 97 ± 3%; 3 years: 31 ± 8% vs 68 ± 8%; P < 0.001). Using the multivariate Cox proportional hazards model, higher annualized BNP changes were significantly associated with increased risk of cardiac events (hazard ratio: 2.73, 95% confidence interval: 1.27-5.86; P = 0.010) after adjustment for age, dyslipidemia, and echocardiographic parameters. CONCLUSIONS: In asymptomatic patients with AS and preserved left ventricular ejection fraction, the use of serial BNP changes may help to anticipate development of class I indication for aortic valve replacement.
BACKGROUND: The aim of this study was to determine the impact on the outcome of serial B-type natriuretic peptide (BNP) changes during follow-up in asymptomatic patients with ≥ moderate aortic stenosis (AS) and preserved left ventricular ejection fraction. METHODS: We prospectively screened 69 patients who underwent comprehensive transthoracic echocardiography, BNP level measurement at baseline and after every 6 or 12 months. Annualized BNP changes were calculated as the difference between the last and baseline BNP measurements divided by the duration of follow-up. The primary endpoint was the occurrence of symptoms, aortic valve replacement, or cardiovascular death. RESULTS: During a follow-up of 30 ± 19 months, 43 patients experienced a cardiac event. These patients were significantly older (73 ± 9 vs 65 ± 16 years; P = 0.010), had more often dyslipidemia (79% vs 42%; P = 0.038), more severe AS (peak velocity: 3.9 ± 0.6 vs 3.5 ± 0.6 m/s; P = 0.002), larger indexed left atrial area (10.2 ± 2.5 vs 8.7 ± 1.9 cm(2)/m(2); P = 0.006), and a higher increase in annualized BNP (+90 ± 155 vs +7 ± 49 pg/mL/y; P = 0.010). Patients with higher annualized BNP changes (> 20 pg/mL/y) had a significantly lower cardiac event-free survival (1 year: 63 ± 8% vs 97 ± 3%; 3 years: 31 ± 8% vs 68 ± 8%; P < 0.001). Using the multivariate Cox proportional hazards model, higher annualized BNP changes were significantly associated with increased risk of cardiac events (hazard ratio: 2.73, 95% confidence interval: 1.27-5.86; P = 0.010) after adjustment for age, dyslipidemia, and echocardiographic parameters. CONCLUSIONS: In asymptomatic patients with AS and preserved left ventricular ejection fraction, the use of serial BNP changes may help to anticipate development of class I indication for aortic valve replacement.
Authors: Edina Hadziselimovic; Anders M Greve; Ahmad Sajadieh; Michael H Olsen; Y Antero Kesäniemi; Christoph A Nienaber; Simon G Ray; Anne B Rossebø; Ronnie Willenheimer; Kristian Wachtell; Olav W Nielsen Journal: JAMA Cardiol Date: 2022-04-01 Impact factor: 30.154
Authors: Frederique E C M Peeters; Elton A M P Dudink; Bob Weijs; Larissa Fabritz; Winnie Chua; Bas L J H Kietselaer; Joachim E Wildberger; Steven J R Meex; Paulus Kirchhof; Harry J G M Crijns; Leon J Schurgers Journal: Front Cell Dev Biol Date: 2020-07-10
Authors: Frederique E C M Peeters; Bas L J H Kietselaer; Judith Hilderink; Noreen van der Linden; Marijke Niens; Harry J G M Crijns; Steven J R Meex Journal: Open Heart Date: 2019-05-08