Kargın Ramazan, Esen Ozlem, Pala Selçuk, Akçakoyun Mustafa, Emiroğlu Yunus, Arslan Kürşat, Aung Soe Moe, Barutçu Irfan, Esen Ali Metin, Ozdemir Nihal
Department of Cardiology, Kartal Koşuyolu Heart and Research Hospital, İstanbul, Turkey.
Turk Kardiyol Dern Ars. 2011 Apr;39(3):191-7. doi: 10.5543/tkda.2011.01273.
Plasma brain natriuretic peptide (BNP) level increases with symptoms and severity of mitral regurgitation (MR). We aimed to determine the relationship between plasma BNP levels and echocardiographic parameters in patients with acute and chronic MR.
The study included 55 patients (31 males, 24 females) with isolated moderate-to-severe MR. Of these, 31 patients had acute MR, and 24 patients had chronic MR. All the patients were assessed by transthoracic, transesophageal and Doppler echocardiography and plasma BNP levels were determined.
Clinical characteristics and functional capacity were similar in the two groups. Patients with acute MR had significantly higher left ventricular (LV) ejection fraction (EF) (p=0.001), and significantly lower LV end-systolic diameter (p=0.016), end-systolic volume (p=0.027), end-diastolic diameter (p=0.011), left atrial volume (LAV) (p=0.003), and plasma BNP levels (p=0.036). Effective regurgitation orifice area was also significantly higher in patients with acute MR (p=0.038). In multiple linear regression analysis, the natural logarithm of BNP was significantly correlated with E/Ea ratio (β=0.50, p=0.002) and LAV (β=0.38, p=0.015) in patients with acute MR, and with systolic pulmonary artery pressure (β=0.60, p=0.002) and EF (β=-0.36, p=0.039) in patients with chronic MR.
Although the echocardiographic degree of MR was more pronounced in patients with acute MR, serum BNP levels tended to be lower in this group. Correlation of serum BNP with E/Ea and LAV in this group may be an important finding.
血浆脑钠肽（BNP）水平随二尖瓣反流（MR）的症状和严重程度增加而升高。我们旨在确定急性和慢性MR患者血浆BNP水平与超声心动图参数之间的关系。
该研究纳入了55例孤立性中重度MR患者（31例男性，24例女性）。其中，31例患者为急性MR，24例患者为慢性MR。所有患者均接受经胸、经食管和多普勒超声心动图检查，并测定血浆BNP水平。
两组患者的临床特征和功能能力相似。急性MR患者的左心室（LV）射血分数（EF）显著更高（p = 0.001），左心室收缩末期直径（p = 0.016）、收缩末期容积（p = 0.027）、舒张末期直径（p = 0.011）、左心房容积（LAV）（p = 0.003）和血浆BNP水平显著更低（p = 0.036）。急性MR患者的有效反流口面积也显著更高（p = 0.038）。在多元线性回归分析中，急性MR患者的BNP自然对数与E/Ea比值（β = 0.50，p = 0.002）和LAV（β = 0.38，p = 0.015）显著相关，慢性MR患者的BNP自然对数与收缩期肺动脉压（β = 0.60，p = 0.002）和EF（β = -0.36，p = 0.039）显著相关。
尽管急性MR患者的超声心动图显示的MR程度更明显，但该组患者的血清BNP水平往往更低。该组中血清BNP与E/Ea和LAV的相关性可能是一项重要发现。
