The relationship between severity of mitral valvular stenosis and the level of serum brain natriuretic peptide

Objectives: Although there have been a considerable number of reports about BNP levels in patients with mitral stenosis (MS), the relationship between the brain natriuretic peptid (BNP) level and the severity of MS is not investigated extensively in patients with sinus rhythm. In this study we aimed to evaluate plasma BNP levels in patients with MS and to determine the relation of BNP levels with the anatomic and physiological severity of MS.Materials and methods: Ninety six patients with isolated rheumatic MS and 40 healthy control subjects (group 1) constituted the study population. The patients with MS were classified as those with mild MS (45 patients, group 2), moderate MS (31 patients, group 3) and severe MS (20 patients, group 4). All subjects underwent a detailed echocardiography and venous blood was drawn for BNP levels.Results: Patients with MS had significantly higher BNP levels than control subjects. In addition, the analysis with respect of the severity of MS showed that BNP levels increased significantly from group 1 through to group 4. In correlation analysis, while there was a good correlation between BNP levels with planimetric mitral valve area and pulmonary artery pressure, there was moderate correlation between BNP levels with left atrial diameter, mean and maximum gradients.Conclusion: We demonstrated that plasma BNP levels were correlated with echocardiographic parameters showing the severity of the MS. Natriuretic peptides might be useful in the clinical and echocardiographic evaluation of MS patients as an indicator of disease severit