Elevated NT-proBNP levels indicate higher risk in patients with severe aortic stenosis (AS) and preserved ejection fraction (EF) undergoing transcatheter aortic valve replacement (TAVR). Findings published in Progress in Cardiovascular Diseases evaluated NT-proBNP as a marker of diastolic dysfunction (DD) and clinical outcomes.

This retrospective study included 1,594 patients, of whom 784 had complete diastolic assessment. NT-proBNP levels obtained before and after TAVR were compared with DD parameters including mitral valve E/e', tricuspid regurgitation velocity, and left atrial volume index.

A cut-off of 802 pg/mL identified DD with 62.3% sensitivity and 54.1% specificity. Higher NT-proBNP tertiles were associated with more advanced New York Heart Association class and worse diastolic indices (p ≤ 0.02). Post-procedure NT-proBNP >802 pg/mL predicted increased mortality, heart failure hospitalizations, and prolonged length of stay (all p < 0.001). Cox regression confirmed NT-proBNP as an independent predictor (odds ratio 1.645; 95% CI 1.244–2.174).

These results support incorporating NT-proBNP into pre-procedural risk stratification to optimize patient selection and management for TAVR.