NT-proBNP in patients with asymptomatic severe aortic stenosis: relation to coronary microvascular function

In this regard, N-terminal pro-B type natriuretic peptide (NT-proBNP) as well as coronary flow reserve (CFR) has important role in patients who have nonobstructive/normal epicardial coronary arteries (11-17). [...]it has been shown that these two parameters closely negatively correlate (18). The prognostic value of NT-proBNP has been demonstrated both in symptomatic and asymptomatic AS patients, with moderate and severe AS and with decreased or preserved LVEF (16,26,27). [...]it is not a surprise that NT-proBNP (together with BNP) is the only biomarker mentioned in European Society of Cardiology guidelines (27) in the context of risk stratification in asymptomatic AS patients and possible elective AVR, (level of evidence II B). [...]demonstrating a prognostic value of NT-proBNP to predict symptom onset or future composite adverse events which include AVR is different from predicting alone all-cause or cardiovascular mortality, and it should not be forgotten. In our previous study, NT-proBNP value of 779.00 pg/l was determined as the best cut-off value for the diagnosis of impaired CFR in asymptomatic moderate or severe AS patients with nonobstructed coronary artery (18). [...]NT-proBNP,