The Correlation of NT-Pro BNP with Echocardiographic Indices Including 3D Vena Contracta Width in the Assessment of Severity of Mitral Regurgitation

Abstract

Introduction: Mitral regurgitation (MR) is a common valvular disease that causes significant morbidity and mortality. The use of multiple echocardiographic indices and hormonal parameters in combination can provide an accurate assessment of MR severity and LV dysfunction in most cases. Aim of study: The aim of this study was to correlate the levels of serum NT-pro BNP with various echocardiographic parameters including 3D vena contracta width in patients with MR. Methods: 74 Patients diagnosed with primary mitral regurgitation in sinus rhythm with no conduction disturbance were included in the study. 2D and Doppler echocardiography indices were calculated. A full-volume 3D color Doppler acquisition was obtained and 3D vena contracta width was calculated and serum BNP levels were obtained. Results: NT-pro BNP levels were increased with symptoms in patients with mitral regurgitation (NYHAI: 4.48 ± 0.06, NYHAII: 5.54 ± 0.78, NYHAIII: 6.68 ± 1.21 pg/ml, p 0.01). NT-pro BNP plasma levels were significantly correlated with MPI (r = 0.945, p 0.01), LVESV (r = 0.706, p 0.01), LVESVI (r = 0.677, p 0.01), LAVI (r = 0.709, p 0.01), MR 2D VC (r = 0.430, p 0.01), 3D VC (r = 0.441, p 0.01), PISA (r = 0.440, p 0.01) and negative correlation with LV ejection fraction (r = 0.846, p 0.01), dp/dt (r = 0.795, p BNP plasma level and LA jet area ratio (P = 0.33). It was observed that there was a significant correlation between 3D VC and PISA levels in patients of mitral regurgitation. However correlation is better in MR with central jet compared to eccentric jet in moderate and severe MR (r = 0.807, 0.817 vs r = 0.617, 0.572). Conclusion: This study showed that NT-pro BNP measurement has the same sensitivity and specificity as echocardiographic indices. Three-dimensional VCA may provide a reliable measurement of ROA, independent of geometric and flow assumptions.