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Recent application of brain natriuretic peptide and N-terminal prohormone brain natriuretic peptide (NT-proBNP) in cardiac valvular disease is very promising.To test the usefulness of NT-proBNP in the assessment of patients with aortic or mitral regurgitation.Sixty-seven patients – 23 with aortic and 12 with mitral regurgitation vs. 32 controls – were examined by color Doppler echocardiography, cardiopulmonary exercise testing, Minnesota Living with Heart Failure Questionnaire (MLWHFQ) and plasma NT-proBNP assay at rest (T0) and after maximal physical exercise (T1).NT-proBNP was significantly higher in patients than in controls, both at T0 (298 ± 85 vs. 46 ± 11 pg/ml; P < 0.01) and at T1 (366 ± 106 vs. 50 ± 12 pg/ml; P < 0.01). MLWHFQ score was significantly higher in patients (19 ± 3 vs. 1 ± 0.6; P < 0.001) with a significant inverse correlation with VO2max (r = −0.538, P < 0.001) and a direct correlation with NT-proBNP (T0: r = 0.415, P < 0.01; T1: r = 0.458, P < 0.01). NT-proBNP was inversely correlated with VO2max (T0: r = −0.444, P < 0.001; T1:r = −0.428, P < 0.001) and directly correlated with left atrial diameter (T0: r = 0.370, P < 0.01; T1: r = 0.409, P = 0.001), and left ventricular mass index (r = 0.279, P < 0.01, and r = 0.272, P < 0.01). No correlations were found between echocardiographic parameters of valvular disease severity and VO2max, NT-proBNP and MLWHFQ.NT-proBNP is useful in the assessment of the cardiac functional damage secondary to mitral and aortic regurgitation.