PROGNOSTIC VALUE OF BRAIN NATRURETIC PEPTIDE IN PATIENTS WITH RHEUMATIC MITRAL REGURGE UNDERGOING MITRAL VALVE REPLACEMENT
Ahmed Farghaly Ali Ahmed;
Abstract
The natriuretic peptides are endogenous cardiac hormones that are synthesized and released from the myocardium in response to wall stress, BNP and and its N terminal pro BNP are most commonly assessed in clinical settings.
In these prospective cohort study we aimed to assess the prognostic value of BNP in patients with rheumatic severe mitral regurge undergoing mitral valve replacement.
Thirty patients with severe rheumatic mitral regurge were conducted in national heart institute. The mean age was 38.14 ± 10.4 all these patients had a normal laboratory investigations with ejection fraction EF % ≥ 55%. And all of these patients had no any comorbidities.
BNP and N-terminal BNP were assessed preoperatively one hour prior to cardiopulmonary bypass. The mean BNP 118.77± 6.9.
Intra operative data regarding cross clamping not exceed 80 minutes and bypass time not exceed 50 minutes and preservation of posterior mitral valve leaflet were conducted.
Post- operative close follow up of the patients in ICU regarding immediate post- operative complications (bleeding, heart block, infection and re-opening) then follow up the patients up to 6 months later regarding liability for infective endocarditis, stuck valve, heart failure and death.
The results of our study revealed that there were a positive correlation but non- significant statistically between BNP level and LVEDD, LVESD, LAD but there was significant positive correlation between BNP level and Euroscore, parsonnet score, ventilation time, ICU stay and hospital stay.
There were a negative correlation between BNP level and mitral valve mean PG, aortic valve mean PG, PASP (pulmonary artery systolic pressure) and RV diameter but statistically non-significant.
Cut off value of BNP determines post-operative outcome after six months of mitral valve replacement was 110pg/ml.
Our results were in agreement with multiple studies that studied the relationship between BNP level and post operative outcome, ICU stay, hospital stay, Euroscore and parsonnet score but differ in that our patients were younger and healthier with normal EF.
Another larger scale studies should be done with longer follow up duration and with serial BNP measurements to assess the exact importance of BNP in valve surgery in rheumatic heart disease patients.
Integrated risk assessment system using BNP level, Euroscore and parsonnet score have to be done for better assessment of the surgical risk stratification in patients with rheumatic mitral regurge undergoing valve replacement surgery.
In these prospective cohort study we aimed to assess the prognostic value of BNP in patients with rheumatic severe mitral regurge undergoing mitral valve replacement.
Thirty patients with severe rheumatic mitral regurge were conducted in national heart institute. The mean age was 38.14 ± 10.4 all these patients had a normal laboratory investigations with ejection fraction EF % ≥ 55%. And all of these patients had no any comorbidities.
BNP and N-terminal BNP were assessed preoperatively one hour prior to cardiopulmonary bypass. The mean BNP 118.77± 6.9.
Intra operative data regarding cross clamping not exceed 80 minutes and bypass time not exceed 50 minutes and preservation of posterior mitral valve leaflet were conducted.
Post- operative close follow up of the patients in ICU regarding immediate post- operative complications (bleeding, heart block, infection and re-opening) then follow up the patients up to 6 months later regarding liability for infective endocarditis, stuck valve, heart failure and death.
The results of our study revealed that there were a positive correlation but non- significant statistically between BNP level and LVEDD, LVESD, LAD but there was significant positive correlation between BNP level and Euroscore, parsonnet score, ventilation time, ICU stay and hospital stay.
There were a negative correlation between BNP level and mitral valve mean PG, aortic valve mean PG, PASP (pulmonary artery systolic pressure) and RV diameter but statistically non-significant.
Cut off value of BNP determines post-operative outcome after six months of mitral valve replacement was 110pg/ml.
Our results were in agreement with multiple studies that studied the relationship between BNP level and post operative outcome, ICU stay, hospital stay, Euroscore and parsonnet score but differ in that our patients were younger and healthier with normal EF.
Another larger scale studies should be done with longer follow up duration and with serial BNP measurements to assess the exact importance of BNP in valve surgery in rheumatic heart disease patients.
Integrated risk assessment system using BNP level, Euroscore and parsonnet score have to be done for better assessment of the surgical risk stratification in patients with rheumatic mitral regurge undergoing valve replacement surgery.
Other data
| Title | PROGNOSTIC VALUE OF BRAIN NATRURETIC PEPTIDE IN PATIENTS WITH RHEUMATIC MITRAL REGURGE UNDERGOING MITRAL VALVE REPLACEMENT | Other Titles | علاقة البيبتيدالناتيوريتيك الدماغى فى مرضى ارتجاع الصمام الميترالى الروماتيزمى بنتائج ما بعد جراحة تغيير الصمام الميترالى | Authors | Ahmed Farghaly Ali Ahmed | Issue Date | 2014 |
Recommend this item
Similar Items from Core Recommender Database
Items in Ain Shams Scholar are protected by copyright, with all rights reserved, unless otherwise indicated.