Cardiac hypertrophic risk markers of left ventricle and left atrium in chronic heart failure due to aortic and mitral valve disease.

Background: Chronic valvular heart disease leads to systolic dysfunction and left atrial enlargement that ultimately results in heart failure.

Purpose: To investigate prognostic importance of Echocardiography and plasma natriuretic peptide levels that increase as a compensatory response and can be used as predictive markers for cardiac hypertrophy.

Material And Methods: The patients were divided into three groups: 51 with left ventricle hypertrophy due to aortic valve disease; 126 with left atrial enlargement due to mitral valve dysfunction; and 76 with both conditions. Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) plasma levels were measured in all three respective groups showing dilated cardiomyopathy.

Results: The mean left ventricular end-diastolic dimension at 64.3 ± 1.6 mm ( < 0.00) and left atrial dimension at 58.3 ± 3.7 mm ( < 0.00) were significantly high. However, patients with both conditions showed significantly high values for left ventricular end-diastolic dimension (63.3 ± 3 mm,  < 0.00) and left atrial dimension (54.9 ± 4 mm,  < 0.00) when compared with controls. A significant positive correlation was found between plasma natriuretic peptides levels and dilated cardiomyopathy. The mean values of ANP were 173 ± 46.6 pg/mL ( < 0.00), 140.4 ± 42.4 pg/mL ( < 0.00), and 295.1 ± 67.5 pg/mL ( < 0.00), significantly high in all three respective disease groups. The levels of BNP were also significantly high at 189 ± 44.5 pg/mL ( < 0.00), 166.6 ± 36.6 pg/mL ( < 0.00), and 323 ± 69.1 pg/mL ( < 0.00) in the disease groups with left ventricular hypertrophy, left atrial enlargement, and the disease group showing both characteristics, respectively.

Conclusion: Significant positive associations were found between left ventricle hypertrophy and left atrial enlargement with ANP and BNP.