Background: Rapid progression of aortic stenosis (AS) is associated
with poor outcomes, and the impact of B-type natriuretic peptide (BNP) on AS
progression remains unknown. Objectives: The purpose of the present
study was to investigate the association between BNP level and the AS progression
rate. Methods: From January 2016 to June 2021, 200 AS patients with
progression who had at least two transthoracic echocardiograms with a maximum
interval of 180 days were retrospectively analyzed. Rapid progression of AS was
defined as the annual increase of aortic jet velocity (Vmax) 0.3
m/s/year. For analyses, both the log-transformed BNP and the BNP ratio were used.
The linear regression and binary logistic regression analyses were used to
determine the association between BNP and the AS progression.
Results: At a median echocardiographic follow-up of 595 days,
the annual median (interquartile) progression of Vmax was 0.26 (0.09–0.58)
m/s/year. Patients with rapid progression had higher age, log BNP, and higher
percentage of diabetes and male gender. Higher tertiles of log BNP and BNP ratio
had more rapid increase in Vmax (p = 0.018 and 0.033, respectively). BNP
ratio significantly correlated with Vmax progression in univariate and
multivariate linear regression analyses (p 0.001 and p =
0.001, respectively). Moreover, both the univariate and multivariate binary
logistic regression analyses showed that the log BNP and BNP ratio were
associated with the rapid progression of AS (p 0.050 for all).
Conclusions: Higher BNP was independently associated with the
rapid progression of AS.