• 作者：N煤ria Farr茅 ; Miquel G贸mez ; Luis Molina ; Mercedes Cladellas ; Mireia Bl茅 ; Cristina Roqueta ; Maria Soledad Ascoeta ; Josep Comin-Colet ; Joan Vila ; Jordi Bruguera
• 关键词：BNP ; pé ; ptido natriuré ; tico tipo B ; EA ; estenosis aó ; rtica ; NT-proBNP ; fracció ; n aminoterminal del propé ; ptido natriuré ; tico tipo B ; RVA ; recambio valvular aó ; rtico ; Vmá ; x ; velocidad má ; xima
• 刊名：Revista Espa?ola de Cardiología
• 出版年：January, 2014
• 年：2014
• 卷：67
• 期：1
• 页码：52-57
• 全文大小：309 K

Introduction and objectives

Our objective was to assess the prognostic value of NT-proBNP in patients with asymptomatic moderate/severe aortic stenosis and to validate an adapted Monin score using natriuretic peptide levels in our setting.

Methods

Prospective study of 237 patients with degenerative asymptomatic moderate/severe aortic stenosis. NT-proBNP was determined in all patients, who were then followed up clinically. The adapted Monin score was defined as follows: (peak velocity [m/s]脳2)+(logn NT-proBNP脳1.5)(+1.5 if woman). A clinical event was defined as surgery, hospital admission due to angina, heart failure or syncope, or death.

Results

A total of 51% were women, and the mean age was 74 years. Mean (SD) echocardiographic values were as follows: peak velocity 4.14 (0.87) m/s; mean gradient, 43.2 (16.0) mmHg; aortic valve area, 0.87 (0.72) cm², and aortic valve area index, 0.49 (0.14) cm²/m². The median NT-pro-BNP value was 490.0 [198.0-1312.0] pg/mL. There were 153 events during follow-up (median 18 months). The optimum NT-proBNP cut-point was 515 pg/mL, giving event-free survival rates at 1 and 2 years of 93% and 57%, respectively, in patients with NT-proBNP <515 pg/mL compared with 50% and 31% in those with NT-proBNP &gt;515 pg/mL. Patients were divided into quartiles based on the Monin score. Event-free survival at 1 and 2 years was 87% and 79% in the first quartile, compared with 45% and 28% in the fourth quartile, respectively.

Conclusions

NT-proBNP determination provides prognostic information in patients with asymptomatic moderate/severe aortic stenosis. The adapted Monin score is useful in our setting and allows a more precise prognosis than does the use of NT-proBNP alone.

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