The Effect of Balloon Mitral Valvuplasty on BNP Plasma Level in Mitral Stenosis

M. Mahjoob, Roxana Sadeghi, Mohammad Haji Aghajani, Naser Kachoueian, Pardis Jolfaei, M. Nosrati, Mahshid Haghi
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Abstract

Background: Mitral valve stenosis (MS), which could be progressive, is one of the most important valvular disorders in developing countries. Percutaneous transvenous mitral commissurotomy (PTMC) is a well-accepted treatment option for dealing with symptomatic MS. Brain natriuretic peptide (BNP) has been used as a prognostic marker for clinical outcomes in patients with heart failure and acute coronary syndrome routinely. Objectives: This study aimed to determine the relationship between BNP levels and hemodynamic parameters in patients with MS who underwent PTMC. Methods: In this case-control study, 90 patients with severe isolated rheumatic mitral stenosis and undergoing PTMC were enrolled. In the study group, BNP levels were measured by performing radioimmunoassay on all participants 30 minutes before PTMC and 24 hours after PTMC. Data were analyzed using SPSS, and P-value < 0.05 was considered significant. Results: Fifty patients with MS who underwent PTMC were included in this study. The level of BNP before PTMC was 473.78 ± 66.95 pg/dL in patients with MS. The level of BNP in patients after PTMC reached 341.54 ± 48.3 pg/dL, which was indicative of a significant reduction in the level of BNP after PTMC (P-value = 0.006). Conclusions: A considerable decline was observed in the serum level of BNP following a successful PTMC, which was indicative of an improvement in clinical and hemodynamic status; hence, it was reasonably suggested that the serum level of BNP was effective in evaluating the response from patient with severe MS to PTMC.
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球囊二尖瓣成形术对二尖瓣狭窄患者血浆BNP水平的影响
背景:二尖瓣狭窄(MS)是发展中国家最重要的瓣膜疾病之一,可能是进行性的。经皮经静脉二尖瓣合舒术(PTMC)是治疗症状性多发性硬化症(ms)的一种广为接受的治疗选择。脑钠肽(BNP)已被常规用作心衰和急性冠状动脉综合征患者临床结局的预后指标。目的:本研究旨在确定接受PTMC的MS患者BNP水平与血流动力学参数的关系。方法:在本病例对照研究中,纳入90例重度孤立性风湿性二尖瓣狭窄并行PTMC的患者。在研究组中,通过对所有参与者在PTMC前30分钟和PTMC后24小时进行放射免疫测定来测量BNP水平。数据采用SPSS分析,p值< 0.05为差异有统计学意义。结果:50例MS患者行PTMC纳入本研究。ms患者PTMC治疗前BNP水平为473.78±66.95 pg/dL, PTMC治疗后BNP水平为341.54±48.3 pg/dL,提示PTMC治疗后BNP水平明显降低(p值= 0.006)。结论:PTMC成功后血清BNP水平明显下降,这表明临床和血流动力学状况有所改善;因此,有理由认为血清BNP水平是评价重度MS患者PTMC疗效的有效指标。
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