Finally, the cut-off value of the BNP level by the ROC curve coul

Finally, the cut-off value of the BNP level by the ROC curve could not be validated in a subsequent patient group because of the low prevalence of severe TR. Despite these limitations, we believe

that the values suggested in the present study can aid in clinical decision-making and can guide future research regarding this issue. In conclusion, the present study demonstrated that in patients with isolated, severe TR, an elevation in BNP level is present and biologically Inhibitors,research,lifescience,medical active and reflects the hemodynamic interaction of RV and LV. Furthermore, elevated levels of BNP are independent predictors of mortality and morbidity after corrective surgery. Thus, the BNP level emerged as a biomarker of the severity of TR consequences and of poor clinical outcome in patients with isolated Inhibitors,research,lifescience,medical TR. Measurement of the BNP should be considered in patients with isolated TR to support the clinical decision-making process. These findings should be further evaluated in larger clinical trials. Acknowledgements This study was supported by Inhibitors,research,lifescience,medical a grant from Korea Institute of Medicine and the Korea Healthcare Technology R&D Project, Ministry for Health, Welfare, and Family Affairs, Republic

of Korea (A090458).
Aortic valvular stenosis (AVS) is a chronic and progressive disease. According to previous study in Western population, it has been shown that the rate of aortic jet velocity progression is approximately 0.3 meter/second/year (m/s/yr), the aortic valve area (AVA) decreases Inhibitors,research,lifescience,medical by 0.1 cm2/yr and the mean gradient increases by 7 to 8 mmHg/yr.1-4) Also, the rate of hemodynamic progression is associated with the severity of AVS, old age, valve calcification, and concurrent coronary artery

disease.3-6) Recently, it has been reported that there was ethnic differences in aortic valve (AV) thickness and calcification7),8) which may play a role in AVS progression. However, the study of the progression rate of AVS in the Korean population is rare.9) Therefore, the present study was performed to evaluate the progression rate of AVS in Korean patients Inhibitors,research,lifescience,medical and to determine clinical, echocardiographic, and biochemical characteristics that may have a bearing on the progression of this common clinical problem. Methods Study population We retrospectively analyzed echocardiograms of all patients with AVS diagnosed the by 2-D and Doppler echocardiography, and selected patients who had at least 2 echocardiography examinations at intervals of 6 months or longer apart from 2003 to 2008. Initially, 541 patients were enrolled. Exclusion criteria were the presense of other significant valvular check details disease, left ventricular systolic dysfunction (left ventricular ejection fraction < 40%), congenital heart disease, cardiomyopathy, permanent pacemaker, uncontrolled tachycardia or bradycardia, and history of cardiac surgery. Finally, 326 out of total 541 patients were included in this study.

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