Archives of the Turkish Society of Cardiology
The relationship between plasma proadrenomedullin level and severity of the disease in patients with isolated rheumatic mitral stenosis [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2021; 49(7): 522-532 | DOI: 10.5543/tkda.2021.39232

The relationship between plasma proadrenomedullin level and severity of the disease in patients with isolated rheumatic mitral stenosis

Ali Rıza Demir1, İlyas Çetin2, Ali Kemal Kalkan1, Yalçın Avcı1, Mehmet Altunova3, Begüm Uygur1, Emre Yilmaz4, Mehmet Ertürk1
1Department of Cardiology, University of Health Science, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
2Department of Cardiology, Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
3Department of Cardiology, İdil State Hospital, Şırnak, Turkey
4Department of Cardiology, Görele State Hospital, Giresun, Turkey


OBJECTIVE
In this study, we aimed to determine the plasma proadrenomedullin (ProADM) levels in patients with rheumatic mitral stenosis (MS), to evaluate the relationship between ProADM levels and the echocardiographic parameters that represent the severity of stenosis and symptoms, and to compare the ProADM and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, which is a well-known marker for rheumatic MS.

METHODS
Our study included 53 consecutive patients with isolated rheumatic MS and 45 volunteers with similar age and gender features. Patients with MS were divided into two groups based on the presence of an indication for intervention. Detailed echocardiographic examinations were performed on all participants, and blood samples were collected to detect the NT-proBNP and ProADM levels.

RESULTS
NT-proBNP and ProADM levels were significantly higher in the rheumatic MS group compared with the control group. In rheumatic MS groups, patients with an indication for intervention had higher levels of NT-proBNP and ProADM compared with patients without an indication for intervention. Moreover, NT-proBNP and ProADM levels were found to be significantly correlated with echocardiographic parameters, which revealed the severity of stenosis in various degrees. Both parameters increased as the New York Heart Association (NYHA) class increased, and this increase had a statistical significance. Additionally, the cut-off values of both parameters (NT-proBNP: 119.9 pg/mL, ProADM: 6.15 nmol/L) could detect patients with an indication for intervention with high sensitivity and specificity rates. NT-proBNP was found to be slightly more effective in this regard.

CONCLUSION
The increased NT-proBNP and ProADM levels in patients with isolated rheumatic MS can help clinicians in distinguishing patients with an indication for intervention by providing additional information to echocardiography.

Keywords: Rheumatic mitral stenosis, NT-proBNP, ProADM

How to cite this article
Ali Rıza Demir, İlyas Çetin, Ali Kemal Kalkan, Yalçın Avcı, Mehmet Altunova, Begüm Uygur, Emre Yilmaz, Mehmet Ertürk. The relationship between plasma proadrenomedullin level and severity of the disease in patients with isolated rheumatic mitral stenosis. Turk Kardiyol Dern Ars. 2021; 49(7): 522-532

Corresponding Author: Ali Rıza Demir, Türkiye
© Copyright 2021 Archives of the Turkish Society of Cardiology
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