BNP and MR

Q: What is the clinical significance of  Brain Natriuretic Peptide (BNP) in Mitral Regurgitation (MR)?


Answer:   Unlike exacerbation of congestive heart failure (CHF), BNP in MR is more of prognostic value and reflection of the clinical outcomes rather than the severity of MR. Interestingly, it is an independent predictive value of mortality with adjustment to all other risk factors including low ejection fraction.

To be of surprise, serum BNP level just more than 31 pg/mL predicts lower five-year survival. Moreover, it also predicts poor outcomes after mitral valve surgery.


Reference:

1. Magne J, Mahjoub H, Pierard LA, et al. Prognostic importance of brain natriuretic peptide and left ventricular longitudinal function in asymptomatic degenerative mitral regurgitation. Heart 2012; 98:584. 

2. Hwang IC, Kim YJ, Kim KH, et al. Prognostic value of B-type natriuretic peptide in patients with chronic mitral regurgitation undergoing surgery: mid-term follow-up results. Eur J Cardiothorac Surg 2013; 43:e1. 

3. Perreas K, Samanidis G, Dimitriou S, et al. NT-proBNP in the mitral valve surgery. Crit Pathw Cardiol 2014; 13:55.