Cardiac hypertrophic risk markers of left ventricle and left atrium in chronic heart failure due to aortic and mitral valve disease.

BACKGROUND

Chronic valvular heart disease leads to systolic dysfunction and left atrial enlargement that ultimately results in heart failure.

PURPOSE

To investigate prognostic importance of Echocardiography and plasma natriuretic peptide levels that increase as a compensatory response and can be used as predictive markers for cardiac hypertrophy.

MATERIAL AND METHODS

The patients were divided into three groups: 51 with left ventricle hypertrophy due to aortic valve disease; 126 with left atrial enlargement due to mitral valve dysfunction; and 76 with both conditions. Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) plasma levels were measured in all three respective groups showing dilated cardiomyopathy.

RESULTS

The mean left ventricular end-diastolic dimension at 64.3 ± 1.6 mm ( < 0.00) and left atrial dimension at 58.3 ± 3.7 mm ( < 0.00) were significantly high. However, patients with both conditions showed significantly high values for left ventricular end-diastolic dimension (63.3 ± 3 mm,  < 0.00) and left atrial dimension (54.9 ± 4 mm,  < 0.00) when compared with controls. A significant positive correlation was found between plasma natriuretic peptides levels and dilated cardiomyopathy. The mean values of ANP were 173 ± 46.6 pg/mL ( < 0.00), 140.4 ± 42.4 pg/mL ( < 0.00), and 295.1 ± 67.5 pg/mL ( < 0.00), significantly high in all three respective disease groups. The levels of BNP were also significantly high at 189 ± 44.5 pg/mL ( < 0.00), 166.6 ± 36.6 pg/mL ( < 0.00), and 323 ± 69.1 pg/mL ( < 0.00) in the disease groups with left ventricular hypertrophy, left atrial enlargement, and the disease group showing both characteristics, respectively.

CONCLUSION

Significant positive associations were found between left ventricle hypertrophy and left atrial enlargement with ANP and BNP.