OBJECTIVE: To assess the sensitivity and specificity of B-type natriuretic peptide (BNP) for identifying symptomatic and asymptomatic patients with severe chronic mitral regurgitation followed up on an outpatient care basis. METHODS: A group of patients with mitral regurgitation underwent electrocardiography, chest teleradiography, venous blood withdrawal, and transthoracic echocardiography. Based on an analysis of the echocardiographic variables, 62 patients had mild and moderate mitral regurgitation (GI) and 34 had severe mitral regurgitation (GII). The discriminating capacity of the BNP for detecting patients with severe mitral regurgitation was assessed by use of ROC curves. RESULTS: The patients' ages ranged from 15 to 63 (mean, 31.7) years, and of the 96 patients, 71 (73%) were females. The BNP values ranged from 0.00 pg/mL to 193 pg/mL. The mean BNP values in GI and GII patients were 18.10 ± 0.74 pg/mL and 50.54 ± 1.46 pg/mL, respectively (P=0.001). The cutoff point for identifying severe mitral regurgitation was 15.40 pg/mL for the best balance between sensitivity and specificity, which were 0.73 and 0.74, respectively. The cutoff point for identifying symptomatic patients with severe mitral regurgitation was 28.40 pg/mL for the best balance between sensitivity and specificity, which were 0.78 and 0.83, respectively. CONCLUSION: The BNP values capable of identifying asymptomatic and symptomatic patients with severe mitral regurgitation are lower than 100 pg/mL, which is considered for the diagnosis of heart failure.
mitral regurgitation; natriuretic peptides; BNP
