Preoperative N-terminal pro-B type natriuretic peptide level can predict the regression of left ventricular mass after valvular surgery in patients with chronic severe mitral regurgitation: One-year follow-up

Background: The aim of this study was to investigate preoperative clinical and echocardiographic characteristics and N-terminal pro-B type natriuretic peptide (NT-proBNP) levels as prognostic factors for regression of the left ventricular (LV) mass after valvular surgery in patients with chronic severe mitral regurgitation (MR). Methods: One hundred seventeen patients undergoing surgery for chronic severe MR were included. Plasma NT-proBNP measurements and echocardiography were performed preoperatively, immediately postoperatively, and at six and 12 months after surgery. Any regression of the LV mass was evaluated by echocardiography. Results: During follow-up, 90 patients (77%) were classified as an LV mass regression group (LVMR), defined as having a postoperative reduction in LV mass indexed against body surface area (LVMI). The remaining 27 (23%) patients were classified as NON-LVMR. The LVMR group was younger (p = 0.029) and had significantly lower ratios of patients with hypertension (p = 0.045) and diuretic use (p = 0.005) than the NON-LVMR group. They also had lower levels of NT-proBNP (median: 446.4 pg/ml versus 1394.0 pg/ml, p = 0.001). In multivariate analysis, higher preoperative NT-proBNP levels were independent predictors of no significant regression of the LV mass (odds ratio = 1.731, 95% confidence intervals 1.052-2.844, p = 0.010). Conclusions: A lower preoperative NT-proBNP level predicted the regression of LV mass after valvular surgery in patients with chronic severe MR. This measure could be used as a biomarker for predicting the postoperative course in such patients.