Correlation between N-terminal pro brain natriuretic peptide and right ventricular performance measured by doppler echocardiography after successful percutaneous balloon mitral valvuloplasty

Mitral stenosis leads to a passive rise of both pulmonary venous and arterial pressures which cause Right Ventricular (RV) pressure overload and RV failure. Brain Natriuretic Peptide (BNP) increases in cases of RV pressure or volume overload. This study aimed to investigate the relationship between N-terminal proBNP (NT-Pro BNP) and echocardiogiaphic determinants of RV function post successful PBMV. A total number of 35 patients with rheumatic mitral stenosis planned for Percutaneous Balloon Mitral Valvuloplasty (PBMV). The control group was composed of 30 age and gender matched healthy volunteers who underwent transthoracic echocardiography and proved to have a normal Left Ventricular (LV) function without valvular heart disease. Both patients and control groups were subjected to thorough history, physical examination and echocardiography with emphasis on mitral valve area, Trans-Mitral Gradient (TMG), pulmonary artery systolic pressure and Tricuspid Annular Plane Systolic Excursion (TAPSE). On the other hand, PW-TDI on lateral side of tricuspid annulus was performed and Sa, Ea, Aa and RV Tei index were calculated. N-terminal proBNP was determined, echocardiographic evaluation and NT-proBNP measurements svere performed before and 24-48 h after PBMV. Pulmonary artery systolic pressure, RV Tei index and NT-ProBNP were significantly decreased while Sa, Ea/Aa and TAPSE were significantly increased (p<0.05) after the increasing MVA post PBMV. The decreased plasma level of NT-ProBNP post PMB V correlated positively with decreased PASP and RV Tei index (p<0.001) and negatively with increased TPASE (p<0.001). The decrease of NT-ProBNP level was correlated with decreased pulmonary artery systolic pressure and improved right ventricular function after PBMV.