Objective    

    To detect the serum levels of brain natriuretic peptide (BNP) and soluble ST2 (sST2) in the patients with tricuspid regurgitation secondary to rheumatic heart disease and estimate the correlation of the BNP and sST2 levels with the severity of secondary tricuspid regurgitation.       Methods       A total of 80 patients with rheumatic heart disease undergoing mitral valve replacement with or without tricuspid surgery in our center from March to May 2014 were enrolled in this study. They were 20 males and 60 males

at a median age of 50 (ranging from 18 o 73 years old). Based on the regurgitation area measured by echocardiography

they were divided into 4 groups (n=20)

that is

local regurgitation group (regurgitation area 2.0 cm

2

group A)

mild regurgitation group (2.0 cm

2

≤area5.0 cm

2

group B)

moderate regurgitation group (5.0 cm

2

area10.0 cm

2

group C)

and severe regurgitation group (area≥10.0 cm

2

group D). The serum levels of BNP and sST2 were measured by ELISA

and the differences were compared among the 4 groups.       Results      Compared with group A (142.71±83.71 pg/mL)

the serum level of BNP was significantly increased in groups C and D (422.52±376.62 and 436.90±290.40 pg/mL

P0.01)

but no statistical difference was seen between the latter 2 groups (P0.05) and between group B (210.62±181.83 pg/mL) and group A. The serum level of sST2 was the highest in group C (74.90±57.51 ng/L) when compared with the other 3 groups (P0.05)

and was 35.25±23.33

48.76±32.83 and 56.87±34.46 ng/L respectively in the groups A

B and D

without significant difference among them (P0.05). Correlation analysis showed that the serum level of BNP had positive correlation with tricuspid regurgitation area (r=0.54

P0.01)

left atrium diameter (r=0.28

P0.01)

right atrium diameter (r=0.40

P0.01) and right ventricular diameter(r=0.32

P0.01)

meanwhile that of sST2 was positively correlated with tricuspid regurgitation (r=0.35

P0.01) and right atrium dia

meter were (r=0.32

P0.01).       Conclusion      Serum BNP and sST2 levels are significantly higher in the patients with moderate and severe tricuspid regurgitation than those with local tricuspid regurgitation

and are positively correlated with the regurgitation area

right atrium diameter and right ventricular diameter.