The value of left ventricular diastolic function and biomarker level in predicting pulmonary hypertension in patients with severe aortic stenosis

ObjectiveTo investigate the predictive value of biomarker combined with conventional echocardiographic parameters of left ventricular diastolic function in preoperative pulmonary systolic pressure(PSP)in patients with severe aortic stenosis(AS).

MethodsSixty patients with severe AS(aortic valve area < 1 cm²)were selected.The PSP ≥ 45 mmHg was diagnosed as the pulmonary arterial hypertension(PH), and the patients were divided into the PH group(18 cases)and nonPH group(42 cases).The routine echocardiography, N-terminal Pro B natriuretic peptide(NT-proBNP)and growth differentiation factor-15(GDF-15)were analyzed.The PSP, left ventricular ejection fraction(LVEF), left ventricular diastolic function parameters E/E', mitral valve deceleration time(MVDT)and left atrial volume were evaluated.The correlation between left ventricular diastolic function parameters and biomarker level, and PSP were analyzed.

ResultsThe E/E' and left atrial volume in PH group were larger than those in nonPH group(P < 0.05 and P < 0.01), and the MVDT in PH group was less than that in nonPH group(P < 0.05).The levels of NT-proBNP and GDF-15 in AS patient were above the normal upper limit.The levels of NT-proBNP and GDF-15 in PH group were higher than those in nonPH group(P < 0.05).The levels of NT-proBNP and GDF-15 in two groups increased with the increasing of PSP(P < 0.01).The ratio of E/E' >14, MVDT>177.5, left atrial volume >100 mL are the independent predictors of PH occurrence in severe patients, and the levels increasing of NT-proBNP and GDF-15 were the reliable predictors of predictive PH(P < 0.01).

ConclusionsThe increasing of the levels of left ventricular diastolic dysfunction and biomarkers can predict the development of pulmonary hypertension in patients with severe AS, and it can provide a basis for early intervention in pulmonary hypertension.