592 N-TERMINAL PRO-B-TYPE NATRIURETIC PEPTIDE LEVEL IS USEFUL TO PREDICT EARLY LEFT VENTRICULAR HYPERTROPHY REGRESSION AFTER AORTIC VALVE REPLACEMENT IN PATIENTS WITH SEVERE AORTIC STENOSIS

Abstract

Background: Early regression of left ventricular (LV) hypertrophy (LVH) after aortic valve replacement (AVR) for severe aortic stenosis (AS) was associated with less fibrosis before AVR and better long-term survival after AVR. However, predicting factors for early LVH regression after AVR has not been fully elucidated. Method: To investigate which preoperative parameters can predict early LVH regression after AVR.Consecutive 87 patients who underwent isolated AVR were analyzed. Preoperative evaluation including echocardiography and N-terminal pro-B-type natriuretic peptide (NT-proBNP) was performed and midterm follow-up echocardiography was done at median 9 months (interquartile range, 7-11 months) after AVR. Presence of complete regression (CR) of LVH at midterm was determined. Result: In multivariate logistic analysis including preoperative echocardiographic parameters, E/e’ ratio was associated with midterm LVH regression (odds ratio 1.11; 95% confidence interval [CI], 1.01–1.22; P=0.035). When NT-proBNP was added to the analysis, logNT-proBNP was found to be the only significant predictor of midterm LVH regression (odds ratio 2.00; 95% CI, 1.08–3.71; P=0.027). By receiver operating characteristic curve analysis, cut-off value of 440 pg/mL of preoperative NT-proBNP level yielded sensitivity of 72% and specificity of 77% for the prediction of LVH regression after AVR. Conclusion: Preoperative NT-proBNP was an independent predictor for early LVH regression after AVR in patients with isolated severe AS and preserved LV systolic function.