| Objective To observe the changes of atrial natriuretic peptide (ANP.) and brain natriuretic peptide (BNP) in plasma of peripheral vein before and after percutanous balloon mitral valvuloplasty (PBMV) and the correlation with hemodynamic parameters in patients with sinus rhythm or atrial fibrillation.Methods Thirty-six patients with rheumatic mitral stenosis undergoing first time successful PBMV were selected to this study. Of these patients , 11 were in sinus rhythm (SR group) and 25 had atrial fibrillation (AF group). The plasma levels of ANP and BNP were assayed before and 1-day and 3-day after procedure. Hemodynamic parameters were measured by echocardiography before and 1-day after procedure. Left atrial pressure ( LAP) and pulmonary artery pressure ( PAP ) were assessed instantly by cardiac catheter before and after PBMV .Results The plasma ANP levels gradually decreased and were 216.09±73.84 pg/ml, 188.70±59.22pg/ml, 140.70±41.53pg/ml (P<0.05) before, at 1-day and 3-day after PBMV, repectively. The levels of ANP in left atrium were higher than in peripheral vein (329.86+115.50pg/ml vs. 216.09±73.84 pg/ml , P<0.01). But BNP levels increased at first, and then decreased significantly (648.05±312.00pg/ml, 716.10±404.57pg/ml, 547.76±320.50pg/ml, P<0.05). Both SR and AF group, ANP levels decreased after PBMV (184.23±87.20 pg/ml vs 120.34±65.29 pg/ml, P<0.05) (231.14±85.81 pg/ml vs 198.21±76.24 pg/ml, P<0.05) . There was significant difference in the changes of ANP between the two groups (64.09±32.89 pg/ml vs 32.93±25.73 pg/ml, P<0.05) . Plasma BNP levels remained unchanged in patients with AF after PBMV(before, 537.23±250.05pg/ml;... |
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