Among the many measures of the left ventricular response to the pressure overload of severe aortic stenosis (AS) are circulating levels of biomarkers that reflect increases in wall stress, hypertrophy, inflammation, injury, and fibrosis.1,2 The natriuretic peptides have been the most intensively studied in patients with AS. Brain natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP), ostensibly signals of increased wall stress and myocardial hypertrophy, are elevated in most patients with AS who are symptomatic and may have a potential role in risk stratification of patients with AS without symptoms. Changes in levels of BNP and NT-proBNP in response to aortic valve replacement (AVR), as well as the prognostic implications of persistent elevation of these biomarkers after AVR, have been less well studied.
Bonow RO, O’Gara PT. Natriuretic Peptide Levels After Transcatheter Aortic Valve Replacement. JAMA Cardiol. Published online July 15, 2020. doi:10.1001/jamacardio.2020.2623
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