Does B-type natriuretic peptide (BNP) level predict 1-year survival in patients with low-flow, low-gradient aortic stenosis?
BNP levels >= 550 pg/mL strongly predict reduced 1-year survival in patients with low-flow, low-gradient aortic stenosis, including those undergoing valve replacement.
BACKGROUND: The prognostic value of B-type natriuretic peptide (BNP) is unknown in low-flow, low-gradient aortic stenosis (AS). We sought to evaluate the relationship between AS and rest, stress hemodynamics, and clinical outcome. METHODS AND RESULTS: BNP was measured in 69 patients with low-flow AS (indexed effective orifice area 1.0 cm2). BNP was inversely related to ejection fraction at rest (Spearman correlation coefficient r(s)=-0.59, P or = 550 pg/mL was only 47+/-9% versus 97+/-3% with BNP or = 550 pg/mL (53+/-13% versus 92+/-7%). CONCLUSIONS: BNP is significantly higher in truly severe than pseudosevere low-gradient AS and predicts survival of the whole cohort and in patients undergoing valve replacement.
Bergler‐Klein et al. (Tue,) studied this question.
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