Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, 100029 Beijing, China.
Beijing Institute of Heart, Lung and Blood Vessel Diseases, 100029 Beijing, China.
Rev Cardiovasc Med. 2022 Feb 22;23(2):75. doi: 10.31083/j.rcm2302075.
Rapid progression of aortic stenosis (AS) is associated with poor outcomes, and the impact of B-type natriuretic peptide (BNP) on AS progression remains unknown.
The purpose of the present study was to investigate the association between BNP level and the AS progression rate.
From January 2016 to June 2021, 200 AS patients with progression who had at least two transthoracic echocardiograms with a maximum interval of 180 days were retrospectively analyzed. Rapid progression of AS was defined as the annual increase of aortic jet velocity (Vmax) ≥0.3 m/s/year. For analyses, both the log-transformed BNP and the BNP ratio were used. The linear regression and binary logistic regression analyses were used to determine the association between BNP and the AS progression.
At a median echocardiographic follow-up of 595 days, the annual median (interquartile) progression of Vmax was 0.26 (0.09-0.58) m/s/year. Patients with rapid progression had higher age, log BNP, and higher percentage of diabetes and male gender. Higher tertiles of log BNP and BNP ratio had more rapid increase in Vmax ( = 0.018 and 0.033, respectively). BNP ratio significantly correlated with Vmax progression in univariate and multivariate linear regression analyses ( < 0.001 and = 0.001, respectively). Moreover, both the univariate and multivariate binary logistic regression analyses showed that the log BNP and BNP ratio were associated with the rapid progression of AS ( < 0.050 for all).
Higher BNP was independently associated with the rapid progression of AS.
主动脉瓣狭窄（AS）的快速进展与不良预后相关，而 B 型利钠肽（BNP）对 AS 进展的影响尚不清楚。
本研究旨在探讨 BNP 水平与 AS 进展率之间的关系。
回顾性分析了 2016 年 1 月至 2021 年 6 月期间至少有两次经胸超声心动图检查且最大间隔为 180 天的 200 例进展性 AS 患者。AS 快速进展定义为主动脉射流速度（Vmax）每年增加≥0.3m/s/年。对于分析，同时使用了 BNP 的对数转换值和 BNP 比值。线性回归和二项逻辑回归分析用于确定 BNP 与 AS 进展之间的关系。
在中位超声心动图随访 595 天期间，Vmax 的年中位数（四分位间距）进展为 0.26（0.09-0.58）m/s/年。快速进展患者的年龄较大、log BNP 较高、糖尿病和男性比例较高。log BNP 和 BNP 比值的较高三分位数 Vmax 增加更快（分别为 0.018 和 0.033）。在单变量和多变量线性回归分析中，BNP 比值与 Vmax 进展显著相关（<0.001 和 =0.001）。此外，单变量和多变量二项逻辑回归分析均显示，log BNP 和 BNP 比值与 AS 的快速进展相关（所有<0.050）。
较高的 BNP 与 AS 的快速进展独立相关。
