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Background: Left ventricular (LV) function can be masked in patients with chronic LV volume overload. We evaluate the usefulness of N-terminal pro B type natriuretic peptide (NT-pro BNP) and Tei-index in predicting postoperative LV function and in-hospital events (IHE) in patients with chronic severe mitral or aortic regurgitation (MR or AR).Methods: Fifty six patients (55.6±15.2 years old, 32 females, 38 MR) with severe MR or AR who underwent valve surgery were enrolled. Postoperative LV ejection fraction, the duration for hospital stay, and IHE were analyzed.Results: At baseline, the level of NT-pro BNP was 1304.4±1967.4 pg/ml, LV ejection fraction (EF) was 57.9±15.5 %, and Tei-index was 0.52±0.13. NT-pro BNP was significantly correlated with Tei-index (r=0.46), but not with LVEF (r=-0.28). LVEF and Tei-index following valve surgery were 54.7±11.1 % and 0.65±0.19. Tei-index was significantly increased following valve surgery (0.52±0.13 to 0.65±0.19, p < 0.001). NT-pro BNP was significantly correlated with postoperative LVEF (r=-0.48) and Tei-index (r=0.61). Baseline Tei-index was also significantly correlated with postoperative LVEF (r=-0.67) and Tei-index (r=0.72). Only the level of NT-pro BNP was significantly associated with IHE (827.7±1644.7 vs. 2925.2±2291.5 pg/ml, p= 0.03). The duration of in-hospital stay was significantly correlated with NT-pro BNP (r=0.74), postoperative LVEF (r=-0.45), and postoperative Tei-index (r=0.43).Conclusion: NT-pro BNP and Tei-index before valve surgery could predict postoperative LV function and IHE in patients with chronic severe MR or AR. Therefore, the measurementof NT-pro BNP and Tei-index before valve surgery would be very useful for the post-operative risk stratification.