BNP in mitral valve restrictive annuloplasty for ischemic mitral regurgitation

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• 作者：Domenico Paparella ; Pietro Giorgio Malvindi ; Roberta Romito ; Massimo Iacoviello ; Giuseppe Visicchio ; Francesca Di Serio ; Stefano Favale ; Luigi de Luca Tupputi Schinosa
• 关键词：Congestive heart failure ; Coronary disease ; Myocardial infarction ; Valve disease ; Functional mitral regurgitation ; Brain natriuretic peptide
• 刊名：International Journal of Cardiology
• 出版年：2009
• 出版时间：September 2009
• 年：2009
• 卷：137
• 期：1
• 页码：57-60
• 全文大小：123 K

文摘

Restrictive annuloplasty with undersized mitral rings is used to correct functional mitral regurgitation (MR) in patients with ischemic left ventricular dysfunction. Seventeen patients with severe coronary artery disease, previous myocardial infarction, moderate/severe functional MR and heart failure symptoms were prospectively evaluated. All patients received CABG associated with restrictive annuloplasty. Preoperatively and 6 months after the operation, clinical evaluation, echocardiography and blood sampling for BNP measurement were performed. Operative mortality occurred in 1 patient. MR degree decreased from 3.8 ± 0.3 to 1.0 ± 0.7 (p < 0.01), LVEF increased from 36 ± 11 % to 43 ± 8 % (p < 0.05), left ventricular end diastolic diameters changed from 54.7 ± 5.2 mm to 51.5 ± 5.8 mm (p = 0.51). NYHA class improved from 2.94 ± 1.02 to 1.21 ± 0.42 (p < 0.01). Mean plasma BNP levels decreased from 471 ± 248 pmol/l to 55.6 ± 52.8 pmol/l (p < 0.05). Restrictive mitral annuloplasty is a safe procedure to be associated to CABG operation. We demonstrated mid-term reduction of BNP plasma values after MR correction thus suggesting the effectiveness of surgical treatment in modifying natural history of the disease.