Studies that investigate the secretion of BNP in diseases affecting the atrium are rare. The relationship between N-terminal proBNP (NT-proBNP) and the echocardiographic (TTE) and hemodynamic data were studied in cases of pure and isolated rheumatic mitral stenosis (RMS). 67 patients with MS (41±11 years), and 29 healthy individuals (age 36±11 years) were included in the study. Detailed TTE was performed before, one and six months after PMC. We measured NT pro BNP in systemic venous and left atrial (LA) before, immediately after, and one and 30 days after the procedure.

The plasma levels of NT-proBNP were significantly higher in MS patients than in controls (103.2±116.8 VS 21.5±8.5pg/mL, p=0.004).We revealed a strong correlation between levels of NT pro-BNP in peripheral vein (PV) and in LA (r=0.819, p=0.001). NT-proBNP was higher in the LA than PV. We releaved a positive correlation with LA volume (0.470, p=0.001 and p=0.001, 0.681 respectively at the LA and at the PV), the absolute value of LV strain (r=0.524, p=0.001 and r=0.568, p=0.001) and the pulmonary artery pression (PAP) (r=0.312, p=0.01 and r=0.586 p=0.001). Negative correlations with LVEF (r=–0.421, p=0.001 and r=-0,462, p=0.000) and the longitudinal movement of the VD (r=-0,380, p=0.002 and r=–0,374, p=0.001) were observed. NT pro BNP falls immediately after PMC IN the sinus rhythm (SR) group patients but not in the atrial fibrillation (AF) group. Moreover, LA remodeling at six months is more pronounced in SR (SOG=0.04±0.07 VS 0.02±0.06 in the AF group; LA volume=5.94±6.5 VS 1.17±8.6

In patients with RMS, NT-proBNP was positively correlated with LA enlargement and the PAP and could be a valuable marker to reflect the structural changes of the LA aftercmP, in patients with SR but not in those with AF.