NT‐proBNP correlates with right heart haemodynamic parameters and volumes in patients with atrial septal defects

Abstract

Background: To investigate the role of N-terminal pro-BNP (NT-proBNP) for the estimation of right heart failure and pulmonary pressure in patients with atrial septal defects (ASD) before and after percutaneous defect closure. Methods: We performed correlation analysis for NT-proBNP and right ventricular systolic pressure (RVSP) as well as right ventricular enddiastolic and endsystolic volume (RVEDV, RVESV) determined by cardiac magnetic resonance imaging (MRI) before and up to one year following ASD closure. Additionally NT-proBNP concentrations were correlated with right atrial (RA) and RV enddiastolic pressure (RVEDP), ASD size and interatrial left-to-right shunt. Results: Baseline RVSP was 33 ± 8 mmHg, which decreased significantly during follow-up. Initially, NT-proBNP levels were 240 ± 93 pg/ml. After closure, a reduction to 116 ± 62 pg/ml was obvious (p < 0.01). Baseline MRI showed enlarged RV volumes in all individuals. At six and twelve months follow-up a significant reduction of RVEDV and RVESV was apparent. A positive correlation was noted between RV volumes and NT-proBNP (r = 0.65, p < 0.05). Furthermore RA pressure, RVEDP, RVSP and left-to-right shunt significantly correlated to peptide levels. No correlation was seen between ASD size and NT-proBNP. Conclusion: NT-proBNP correlates to right ventricular dilatation, pulmonary pressure and left-to-right shunt in volume load of the right heart caused by an underlying ASD.

Cardiac biomarkers in children with congenital heart disease

“…In heart disease due to a left-to-right shunt, such as ASDs and VSDs, NT-proBNP levels are high when the Qp/Qs is high, and the fact that this decreases after surgery indicates that congestive HF due to volume overload may result in increased NT-proBNP levels. [41][42][43] Moreover, right ventricular volume overload due to pulmonary regurgitation after surgery for TOF also leads to increased NT-proBNP levels. [44,45] NT-proBNP levels have been reported as a useful marker of HF in patients with single ventricular circulation after Fontan surgery.…”

Two‐dimensional knowledge‐based volumetric reconstruction of the right ventricle documents short‐term improvement in pulmonary hypertension

“…[36][37][38] This is not surprising as wall stress modulates BNP gene expression, 39,40 and one of the main determinants of wall stress is end-diastolic volume. 42 We have clinically followed patients for a further 8.3 months and observed that remodeling of RV volumes was associated with clinical worsening. In a similar study by Gan et al, changes in NT-proBNP levels significantly correlated with change in right ventricular volume, the strongest correlation was seen with changes in right ventricular ejection fraction.…”

Rotura extensa de septo interventricular por traumatismo torácico cerrado

“…Sin embargo, hasta el momento actual no se ha descrito el comportamiento del péptido natriurético en la patología traumática cardíaca, por lo que, al tratarse de pacientes jóvenes y sin cardiopatía previa, podría estar razonablemente justificada su determinación. Sí están descritos casos que correlacionan valores de proBNP con la gravedad del shunt izquierda-derecha, PAP y dilatación de cavidades derechas en pacientes adultos y pediátricos con defectos septal auricular o ventricular no traumáticos 17,18 .…”