Brain natriuretic peptide as a biomarker of systemic right ventricular function in patients with transposition of great arteries after atrial switch operation

Chow, P. H.; Cheung, Eddie W.Y.; Chong, Chun-yin; Lun, Kin‐Shing; Yung, TC; Wong, Kin-tak; Chau, Anson C.M.; Cheung, Yiu‐fai

doi:10.1016/j.ijcard.2007.06.004

Cited by 30 publications

(21 citation statements)

References 36 publications

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“…In addition, an association between BNP levels and NYHA functional class was reported in 3 studies (Table 2) (27,29,33). A significant negative correlation between BNP levels and RV function measured by either CMR or echocardiography was found in 5 of 8 studies (correlation coefficients ranging from r ϭ Ϫ0.42 to r ϭ Ϫ0.54) ( Table 2) (24,25,29,33,34). Secondly, a weaker but still significant positive correlation between BNP and end-diastolic RV volume was observed (24,25,29,33).…”

Section: Resultsmentioning

confidence: 94%

“…A significant negative correlation between BNP levels and RV function measured by either CMR or echocardiography was found in 5 of 8 studies (correlation coefficients ranging from r ϭ Ϫ0.42 to r ϭ Ϫ0.54) ( Table 2) (24,25,29,33,34). Secondly, a weaker but still significant positive correlation between BNP and end-diastolic RV volume was observed (24,25,29,33). Furthermore, a positive correlation was found between the severity of tricuspid valve regurgitation (TR) and BNP (27,35).…”

Section: Resultsmentioning

confidence: 96%

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The Usefulness of Brain Natriuretic Peptide in Complex Congenital Heart Disease

Eindhoven¹,

Bosch²,

Jansen³

et al. 2012

Journal of the American College of Cardiology

148

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Brain natriuretic peptide (BNP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) are well-established markers for heart failure in the general population. However, the value of BNP as a diagnostic and prognostic marker for patients with structural congenital heart disease (CHD) is still unclear. Therefore, the purpose of this study was to evaluate the clinical utility of BNP in patients with CHD. We executed a PubMed literature search and included 49 articles that focused on complex congenital heart defects such as tetralogy of Fallot, systemic right ventricle, and univentricular hearts. Data on BNP measurements and cardiac function parameters were extracted. In all patients after correction for tetralogy of Fallot, BNP levels were elevated and correlated significantly with right ventricular end-diastolic dimensions and severity of pulmonary valve regurgitation. Patients with a systemic right ventricle had elevated BNP levels, and positive correlations between BNP and right ventricular function were seen. In patients with a univentricular heart, elevated BNP levels were observed before completion of the Fontan circulation or when patients were symptomatic; a clear association between BNP and New York Heart Association functional class was demonstrated. In conclusion, this review shows an overall increase in BNP values in complex CHD, although differences between types of congenital heart anomaly are present. As BNP values differ widely, conclusions for individual patients should be drawn with caution. Further investigation with sequential BNP measurement in a large, prospective study is warranted to elucidate the prognostic value of BNP assessment in patients with CHD.

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Section: Resultsmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 96%

The Usefulness of Brain Natriuretic Peptide in Complex Congenital Heart Disease

Eindhoven¹,

Bosch²,

Jansen³

et al. 2012

Journal of the American College of Cardiology

148

View full text Add to dashboard Cite

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“…However, these data were inconsistent and did not indicate a clear relation between NT-proBNP, RV systolic function at rest and exercise capacity [30,31]. This observation may be in part related to heterogeneity of the patient groups and the methods used for evaluating systolic ventricular function.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, there is only 1 study demonstrating a relation of BNP and selected echocardiographic parameters of diastolic function. In this study, however, for statistical reasons logarithmically transformed BNP values were used and patients from the control group were included to assess a possible relation between BNP and echocardiographic parameters of diastolic function [30]. …”

Section: Discussionmentioning

confidence: 99%

Relation of Diastolic and Systolic Function, Exercise Capacity and Brain Natriuretic Peptide in Adults after Mustard Procedure for Transposition of the Great Arteries

et al. 2010

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Objectives: To evaluate the relation of echocardiographic parameters of diastolic function, exercise capacity (expressed as peakVO₂) and NT-proBNP in patients with transposition of the great arteries (TGA) and Mustard procedure. Methods: Diastolic function was determined by measuring tricuspid flow velocities (Ea/Aa ratio), isovolumic relaxation time (IVRT), and deceleration time (DT). E/Ea ratios were calculated. For assessment of systolic function, CMR was applied. Results: E/A (r = 0.07, p = 0.66), E/Ea medial (r = 0.03, p = 0.84), E/Ea lateral (r = –0.01, p = 0.92), IVRT (r = –0.13, p = 0.44), and DT (r = –0.05, p = 0.76) were not correlated with peakVO₂. NT-proBNP showed a significant correlation with IVRT (r = 0.44, p = 0.004) and Ea/Aa medial (r = –0.34, p = 0.025). No correlation was found between RV systolic function and peakVO₂ (r = 0.07, p = 0.63). Conclusions: Exercise capacity in patients with TGA and Mustard procedure is not related to echocardiographic parameters of diastolic function. NT-proBNP is associated with selected echocardiographic parameters of diastolic function.

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“…BNP has been found to be elevated in patients with a systemic RV, and the level of BNP correlated with a deterioration in clinical status, declining right ventricular ejection fraction (RVEF), decreasing exercise capacity, and worsening TR. [153][154][155] A specific cutoff value that signifies the presence of ventricular dysfunction or discriminates HF from other diagnoses in the patient with a systemic RV has not been defined.…”

Section: Assessmentmentioning

confidence: 99%