Percutaneous mitral commissurotomy (PMC) is the gold standard technique for the management of severe rhumatismal mitral stenosis (MS). We investigated the utility of BNP, NT pro-BNP, MR pro-ANP, CD146 and sST2 in evaluating the success of the PMC procedure.

All 5 biomarkers were measured one day before and one day after the procedure in 43 patients presenting with severe MS (defined as mitral valve area (VA) by planimetry<0.2cm²) and submitted to PMC in 2 large university hospitals in France (CHU Bichat, Paris; CHU Jean Minjoz, Besancon). Patients were classified as procedural success (VA>1.5cm2or increase in VA>0.5cm²) or failure (VA<1.5cm2or increase in VA<0.5cm²) by echocardiography. The absolute decrease in each biomarker between before and after the procedure was compared for each patient using the paired Student t test.

In total, 43 patients were included (80% women, average 63.7 years), of whom 30 (70%) were judged to have a successful procedure by echocardiography; 11 (25%) were classed as procedural failure, and 2 (5%) had a major complication (1 mitral insufficiency requiring surgery, 1 tamponade). Among the 30 patients with procedural success, there was a significant decrease in MR pro-ANP (–40±74, p=0.02) and CD146 (–43±105, p=0.03). There was no significant decrease in patients classed as procedural failures. There was no significant decrease in BNP, NT pro-BNP or sST2 in patients with either successful or failed procedure.

There is a significant decrease in MR pro-ANP and CD146 after successful PMC. The difference is more pronounced in younger patients and in those in sinus rhythm. These two biomarkers could be of use in evaluating the immediate success of PMC.