BNP may serve as prognostic biomarker in valve disease

Degenerative mitral valve disease is a common form of heart disease and affects up to 2% of the population, causing symptoms such as breathlessness. Physicians use echocardiography to diagnose and track the progress of degenerative mitral regurgitation, but adding in the biomarker brain natriuretic peptide (BNP) could help to predict outcomes in patients yet to develop symptoms, according to research presented at the EUROECHO 2011 meeting in Budapest, Hungary.

In degenerative mitral valve disease, the "leaflets" of the mitral heart valve become floppy; the valve does not close properly and blood leaks back from the left ventricle into the left atrium. This increases the pressure in the left atrium, damaging the heart muscle and increasing levels of fluid in the lungs. The team of researchers from the University of Liège, Belgium, carried out echocardiography to assess the stress on the left ventricle in 135 asymptomatic patients with moderate to severe mitral regurgitation, as well as to measure the levels of BNP, which indicate damage to the left atrium and left ventricle.

Raised levels of BNP were linked with a fourfold increase in risk of death or a cardiac event, such as heart attack or angina. The stress on the left ventricle and the volume of the left ventricle were also linked with outcomes.

"It's clear we need to assess all three of them because they are independent and all have an additive value," Dr. Caroline Van De Heyning of the University of Liège told MedPage Today.

Not all patients with mitral regurgitation require surgery, and all forms of surgery carry associated risks. Combining biomarkers and imaging could help physicians monitor the progress of asymptomatic patients and predict when the benefits of surgery, including preventing further heart damage and improving quality of life, could outweigh the risks.

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