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European Journal of Heart Failure 2004 6(6):757-760; doi:10.1016/j.ejheart.2004.04.018
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© 2004 European Society of Cardiology

Plasma brain natriuretic peptide levels in patients with rheumatic heart disease

Zehra Gölbaþya,*, Özgül Uçarb, Ayse Geçer Yükselb, Okan Gülelb, Sinan Aydogdub and Vasfi Ulusoyb

a Department of Cardiology, Ankara Türkiye Yüksek Ihtisas Hospital Attar sok. No: 14/3, GOP, 06700, Ankara, Turkey
b Department of Cardiology, Ankara Numune Education and Research Hospital Ankara, Turkey

* Corresponding author. Tel.: +90-532-632-8480; fax: +90-312-310-3460.. E-mail address: zgolbasi{at}hotmail.com


  Abstract

Background: Brain natriuretic peptide (BNP) is a cardiac hormone secreted from the ventricular myocardium as a response to ventricular volume expansion and pressure overload. Rheumatic heart disease (RHD) is still an important cause of heart failure in developing countries.

Aims: To measure BNP levels in patients with RHD and to determine whether BNP concentrations correlate with clinical and echocardiographic findings.

Methods: Eighty-eight patients with rheumatic valve disease and 24 age- and sex-matched healthy subjects were entered in the study. BNP was measured using the Triage B-Type Natriuretic Peptide test (Biosite Diagnostics, San Diego, CA). Transthoracic echocardiography was performed in all patients to assess the severity of the valve disease and for the measurement of pulmonary artery pressure.

Results: The plasma concentrations of BNP were significantly higher in patients with rheumatic heart disease than in control subjects (232±294 vs. 14±12 pg/ml, p<0.0001). The plasma BNP level was significantly higher in NYHA class III+IV than in class II (463±399 vs. 192±243 pg/ml, p<0.0001) and in NYHA class II than in class I (192±243 vs. 112±135 pg/ml, p<0.001). The independent determinants of higher BNP levels were NYHA functional class and systolic pulmonary artery pressure in multivariate analysis.

Conclusion: We found increased plasma BNP levels in patients with rheumatic heart disease compared with healthy subjects.

Key Words: Brain natriuretic peptide • Mitral stenosis • Rheumatic heart disease • Atrial fibrillation

Received June 27, 2003; Revised February 10, 2004; Accepted April 22, 2004


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