Plasma N-terminal pro BNP and cardiotrophin-1 are elevated in aortic stenosis

Background: Echocardiography with Doppler examination of the aortic valve provides a very accurate assessment of the . .transvalvular gradient and is used to monitor progression of aortic stenosis AS. Plasma brain natriuretic peptide BNP has been shown to correlate with end-systolic wall stress in patients with AS. Aim: We hypothesized that plasma N-terminal . .proBNP NT proBNP and a newly identi®ed cytokine cardiotrophin-1 CT-1, which has been shown to stimulate BNP production at a transcriptional level are elevated in patients with AS and correlate to the maximum trans-valvular aortic . wpressure gradient TVPG. Method: We compared plasma NT proBNP and CT-1 in 15 AS patients ®ve males, mean age 79 w x .x w x.years range 60]94, mean TPVG 39.3 mmHg 20]100 with 10 controls ®ve male, mean age 68 years 56]79. Results are w xexpressed as mean ranges and comparisons were by the Mann]Whitney test. Results: NT proBNP levels were elevated in AS w .x w x.patients 252.9 fmolrml 79.2]541.8 when compared with the controls 157.2 fmolrml 104.7]236.9, P-0.005. Also CT-1 w x w .levels were elevated in AS patients 57.3 fmolrml 33]86.3 when compared with the controls 28.3 fmolrml 6.9]48.3, x P-0.0005. Both NT proBNP and CT-1 levels were correlated to the TVPG rs0.53 and rs0.65, P-0.05 and Ps0.009,. 2.respectively. On best subset analysis the strongest correlate with TVPG was CT-1 R s38 %. The addition of NT proBNP 2.did not improve diagnostic accuracy R s39 %. Conclusion: These results suggest NT proBNP and CT-1 levels increase in proportion to the TVPG and could potentially be used to monitor progression of disease non-invasively. These markers may also be useful to identify the optimum time for surgery in AS. Q 2001 European Society of Cardiology. All rights reserved