Prognostic Value of Plasma B-Type Natriuretic Peptide in the Long-Term Follow-up of Patients With Transposition of the Great Arteries With Morphologic Right Systemic Ventricle After Atrial Switch Operation

Haberger, Stefanie; Hauser, Michael; Braun, Siegmund; Schuster, Tibor; Ewert, Peter; Nagdyman, Nicole; Hess, John; Kaemmerer, Harald

doi:10.1253/circj.cj-15-0348

Cited by 21 publications

(16 citation statements)

References 42 publications

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“…Koch et al 2008 demonstrate a positive correlation between NT‐proBNP and basal right ventricular diameter measured on echo . NT‐proBNP continues to have a role as an important clinical parameter for estimating the appearance of cardiovascular complications and potential risk stratification for events before the patient’s follow‐up to be tailored accordingly . Our study supports this and we routinely measure and track serum NT‐proBNP levels at our yearly routine clinic appointments.…”

Section: Discussionsupporting

confidence: 78%

“…17 An NT-proBNP value of more than 200 pg/mL has been suggested as a cutoff value to predict clinical deterioration. 3,18 In this series, 16 demonstrated that the echocardiography alone is not adequate to assess the right ventricular function accurately. 9 In addition, the traditional transthoracic echo is not always sufficient to precisely interrogate the intra-atrial baffles.…”

Section: Discussionmentioning

confidence: 84%

“…NT‐proBNP is widely accepted as a biomarker of ventricular function and heart failure . An NT‐proBNP value of more than 200 pg/mL has been suggested as a cutoff value to predict clinical deterioration . In this series, 16 patients had an NT‐proBNP value of more than 200 pg/mL and the mean NT‐proBNP was 266.4 pg/mL.…”

Section: Discussionmentioning

confidence: 87%

“…During adult life, such patients are at increased risk of complications; including exercise intolerance, ventricular dysfunction, arrhythmia, tricuspid valve insufficiency, problems relating to the intra‐atrial baffles, and sudden cardiac death. Failure of the systemic right ventricle is a major determinant of morbidity and mortality . In this retrospective review, we examined the clinical progress of our current cohort of patients who have undergone atrial redirection surgery for TGA currently attending the Belfast Trust for the follow‐up and related this to cardiopulmonary exercise testing, serum NT‐pro BNP measurement, and cardiac MRI data.…”

Section: Introductionmentioning

confidence: 99%

“…Failure of the systemic right ventricle is a major determinant of morbidity and mortality. 3 In this retrospective review, we examined the clinical progress of our current cohort of patients who have undergone atrial redirection surgery for TGA currently attending the Belfast Trust for the follow-up and related this to cardiopulmonary exercise testing, serum NT-pro BNP measurement, and cardiac MRI data.…”

Section: Introductionmentioning

confidence: 99%

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32 year follow up of patients following atrial redirection surgery for transposition of the great arteries

Morrison

Grant

McCrossan

et al. 2019

Congenital Heart Disease

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Objective A significant body of patients who have undergone Mustard or Senning procedure require lifelong follow up. In this retrospective review, we examined the cohort of such patients currently attending our center. Design Patients who had undergone either Mustard or Senning procedure were identified. We retrospectively reviewed medical records, recorded demographic information and data regarding the clinical state, NHYA class, cardiopulmonary exercise testing, NT‐proBNP measurement, and recent cardiac MRI findings. Results Forty‐six patients were identified, the mean age was 32.2 years (± 6.1 years), 67.4% were male. Thirty‐two patients (69.6%) had undergone a Senning procedure. The median length of the follow‐up was 32 years. Thirty‐two patients (69.6%) were NHYA class 1. The mean VO2max achieved was 24.2 ± 5.8 mL/min/kg. The mean NT‐proBNP was 266.4 pg/mL (± 259.9 pg/mL). The mean right ventricular end‐diastolic volume (RVEDV) was 212.4 mL ± 73.1 mL (indexed 114.2 mL/m2 ± 34.4 mL/m2). The mean right ventricular ejection fraction (RVEF) was 53.7% ± 7.9%. The mean left ventricular end‐diastolic volume (LVEDV) was 161.5 mL ± 73.7 mL (indexed 87.8 mL/m2 ± 41.1 mL/m2). The mean left ventricular ejection fraction (LVEF) was 59.8% ± 5.7%. There was a significant correlation between right ventricular (RV) size on MRI and NT‐proBNP level. Conclusions We present a relatively well cohort of patients with overall favorable long‐term outcome. The majority of patients are NHYA class 1 and the systemic right ventricular function appears to be well preserved as assessed by MRI. The exercise tolerance is reduced, with the majority of patients achieving around 60% of the estimated VO2max. Regular specialist follow‐up and assessment with advanced imaging at regular intervals remain important for this group.

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Section: Discussionsupporting

confidence: 78%