P721The role of changes of NT-proBNP level during exercise echocardiography in patients with functional ischemic mitral regurgitation qualified for cardiosurgical treatment.


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Abstract

Purpose: The aim of this study was to assess correlation between baseline NT-proBNP level at rest and after 2D echocardiography semi-supine exercise test (ExE) in patients (pts) with at least moderate functional ischemic mitral regurgitation (FIMR) qualified for cardiosurgical treatment - coronary artery by-pass grafting alone (CABGa) or CABG with mitral reconstruction (CABGmr). Materials and methods: A ninety-one of subsequent pts (M 58, 65±7 years), 3-24 weeks after myocardial infarction, presenting at least moderate FIMR (32 pts with severe, 59 with moderate) were prospectively included into the study. Effective regurgitation orifice area (EROA) was used for quantitative IMR assessment (moderate ≥10-20 mm2, severe ≥ 20 mm2). All the pts were qualified for CABG (multiple vessel coronary disease, ejection fraction (EF) 43,4±10%, wall motion score index (WMSI) 1.62±0.36). The pts were referred for CABGa (gr.1; n=39) or CABGmr (gr.2; n=52) based on clinical assessment, 2D, 3D echo and 2D ExE. NT-proBNP level was evaluated before and immediately after ExE.Results: The results of analysis of NT-proBNP level and FIMR size at rest and after ExE in both groups of pts are shown in table 1 (p<0.05:statistical significance). A positive correlation was found between NT-proBNP and EROA at rest (ro= 0,42, p=0,0044) and after ExE (ro = 0,35, p=0,015).Conclusions: 1. Baseline NT-proBNP levels at rest and after ExE are significantly higher in pts with FIMR qualified for CABGmr than in the CABGa group.2. Significant increase of NT-pro-BNP level after exercise in pts with at least moderate FIMR was observed.3. We observed a positive weak correlation between NT-proBNP level and FIMR size at rest as well as after ExE.

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