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￭ S-219 ￭
Change of BNP after Surgery and Its Association with Rhythm Status in Patients with Chronic MR
Department of Internal Medicine, Seoul National University College of Medicine, Korea
*황인창, 김대희, 김용진, 김경희, 이승표, 김형관, 손대원, 오병희, 박영배
Background: B-type natriuretic peptide (BNP) is a useful biomarker of cardiac function in patients with mitral regurgitation (MR). However, the change of BNP in association with rhythm status after corrective surgery has not been studied. Methods: Total 101 patients with chronic severe MR undergoing surgery were prospectively enrolled. BNP assay and echocardiographic studies were conducted before and 6 months after surgery.
Patients were divided into 3 groups according to pre-/postoperative rhythm (sinus→sinus, SS (n=61); AF→sinus, AS (n=28); AF→AF, AA group (n=12)). Results: BNP decreased only in AS group 6 months after mitral surgery (218.0 ± 136.5→94.7 ± 85.1 pg/mL; p<0.001) but not in SS or AA groups (P for interaction = 0.001). However, changes of echocardiographic parameters after surgery were not different among the three groups. In AA group, postoperative left ventricular (LV) end-diastolic dimension and left atrial volume were higher than the other groups.
Significant determinants of BNP were the presence of AF and PASP preoperatively (β = 0.767, p=0.001 for AF; β = 0.022, p=0.019 for PASP), and LVEF postoperatively (β = -0.030, p=0.011). Conclusion: After surgical correction of chronic organic severe MR, BNP decreased only in pa- tients with preoperative AF which was converted to sinus rhythm postoperatively. The reduction of BNP was not observed when rhythm status did not change. BNP activation was associated with the presence of AF and LV systolic dysfunction, suggesting its prognostic value.
￭ S-220 ￭
A Rare Case of Von Hippel-Lindau Disease Combined with Aortic Valve Regurgitation
Department of Cardiology, Dong-A University College of Medicine, Busan, Korea
*Sang Hyeon Kang, Dong Hyun Lee, Young-Dae Kim
Von Hippel-Lindau (VHL) disease is an autosomal dominant hereditary disorder, which is resulted from a germline mutation on the VHL gene.
VHL disease is a multisystemic disorder predisposing to benign or malignant tumors including CNS hemangioblastomas, retinal angiomas, renal cell carcinoma and pheochromocytomas. We report a case of a 24-year-old female who was diagnosed as VHL disease, complicated with pheo- chromocytoma, renal cell carcinoma, retinal hemangioma, cerebellar hemangioblastoma, but initially manifested as aortic valve regurgitation. The subsequent gene study revealed a missense germline mutation in eightieth codon by direct sequencing of the VHL gene, leading to the diagnosis of VHL disease. We report a rare case of VHL disease combined with atypical initial presentation.
