N-terminal pro-B-type natriuretic peptide is associated with clinical outcomes after transcatheter aortic valve replacement

Journal of Cardiothoracic Surgery

Research

Jun Yu¹  Wei Wang¹ 

[1] Department of Structural Heart Disease Centre, National Center for Cardiovascular Diseases, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, A 167, Beilishi Road, Xicheng District, 100037, Beijing, China;

关键词: Aortic valve disease;    NT-proBNP;    Biomarker;    Transcatheter aortic valve replacement;    Risk stratification;   

DOI  :  10.1186/s13019-023-02391-2

 received in 2022-11-28, accepted in 2023-09-30,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundLimited data on the prognostic value of periprocedural changes of plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) after transcatheter aortic valve replacement (TAVR).MethodsData of plasma NT-proBNP were retrospectively collected in 357 patients before TAVR procedure and at discharge from January 1, 2018 to December 31, 2021 in our single center. Patients were grouped as responders and non-responders according to the NT-proBNP ratio (postprocedural NT-proBNP at discharge/ preprocedural NT-proBNP). Responders were defined as NT-proBNP ratio < 1 and non-responders were defined as NT-proBNP ratio ≥ 1. Outcomes were defined according to the Valve Academy Research Consortium (VARC)-3 criteria.ResultsA total of 234 patients (65.5%) and 123 patients (34.5%) were grouped as the responders and the non-responders, respectively. Responders and non-responders were significantly different in both median preprocedural (2103.5 vs. 421.0 pg/ml, p < 0.001) and postprocedural (707.6 vs. 1009.0, p < 0.001) NT-proBNP levels. Patients in the non-responder group were more inclined to have comorbidities of hypertension (73.2% vs. 51.7%, p < 0.001), hyperlipidaemia (46.3% vs. 34.6%, p = 0.031), peripheral vascular disease (20.3% vs. 8.5%, p = 0.001) and pure aortic insufficiency (15.4% vs. 4.3%, p < 0.001). In the contrast, patients in the responder group had higher prevalence of maximum transvalvular velocity (4.6 vs. 4.2 m/s, p < 0.001), reduced left ventricular ejection fraction (58.0% vs. 63.0%, p < 0.001), heart failure (9.4% vs. 2.4%, p = 0.014), mitral regurgitation ≥ moderate (13.7% vs. 4.9%, p = 0.010), tricuspid regurgitation ≥ moderate (12.0% vs. 2.4%, p = 0.002), and pulmonary hypertension (32.9% vs. 13.0%, p < 0.001). Patients in the non-responder group were moderately longer than the responder group in total hospitalization length (14 vs. 12 days, p < 0.001). The non-responder group were significantly associated with cumulative all-cause mortality (p = 0.009) and cardiac mortality (p < 0.001) during the follow-up period.ConclusionsPeriprocedural changes of NT-proBNP is clinically useful for the risk stratification of survival in patients after TAVR.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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