Natriuretic Peptides and Endothelin in Aortic Stenosis and Heart Transplantation

  • Igor Riecansky
  • Martin Vrsansky
  • Katarina Danova
  • Ivan Pechan
Part of the Progress in Experimental Cardiology book series (PREC, volume 10)

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. Echocardiography 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.

In the second group we have studied the development of ANP, BNP and endothelin-1 (ET-1) levels in 17 patients after heart transplantation. The blood samples for were taken before the heart transplantation and on days 1, 3, 5, 7, 14, 21 and 28. ANP and BNP levels decreased after the heart transplantation, with a subsequent rise with a peak on days 5 and 3, respectively. ET-1 levels increased steeply in the 1st day, with a subsequent steady fall to pre-transplant.

Key words

aortic stenosis heart transplant natriuretic peptides endothelin ANP BNP ET-1 

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Copyright information

© Springer Science+Business Media Dordrecht 2004

Authors and Affiliations

  • Igor Riecansky
    • 1
  • Martin Vrsansky
    • 1
  • Katarina Danova
    • 2
  • Ivan Pechan
    • 2
  1. 1.Department of CardiologySlovak Institute of Cardiovascular DiseasesSlovakia
  2. 2.Department of Clinical BiochemistrySlovak Institute of Cardiovascular DiseasesBratislavaSlovakia

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