Natriuretic Peptides and Endothelin in Aortic Stenosis and Heart Transplantation

摘要

Summary. In the first study we have tried to test usefulness of ANP and BNP in the timing of aortic valve surgery. 23 patients were examined and compared to 20 controls. Echocar-diography and 6-minute walk test were performed and pre-, peak- and post-exercise samples were taken from each patient. ANP and BNP plasma concentrations were measured by immuno-radiometric assay.All natriuretic peptide plasma levels exhibited' wide interpatient variability. All ANP and BNP plasma levels were found to be significantly higher than in controls. Both ANP and BNP levels had a non-significant, but rising trend with the NYHA classification. Only ANP showed statistically significant changes with exercise, which, however, did not increase the test validity. There was a correlation between AVG and BNP1,2, but none was found with AVAI and LVMI. Sensitivity of the test to detect'a critical aortic stenosis with AVG >100mmHg was 77% for ANP and 100% for BNP, specificity was 57% and 29%, respectively. However, it was not sensitive enough to detect borderline gradients. Wide inter-patient variability makes the test an insufficient screening tool, however, it could be used to exclude significant aortic stenosis.