The BNP concentrations and exercise capacity assessment with cardiopulmonary stress test in cyanotic adult patients with congenital heart diseases

Microvolt T-wave alternans in adults with complex congenital heart diseases

“…It is proved that deterioration in NYHA classification has an adverse prognostic value for SCD in patients with congenital heart anomaly [7,25,26]. This association might be due to the heart failure--related hypercatecholaminemia that increases the risk of ventricular arrhythmia, simultaneously confirming the rationale for including MTWA into SCD risk stratification in the analyzed population [27]. However, our study neither proved higher NYHA class nor higher serum BNP concentration to increase the probability of abnormal MTWA.…”

“…Other factors contributing to heart failure pathogenesis in patients with that heart anomaly are elevated pulmonary and decreased blood saturation, often coexisting, hence difficult to be analyzed separately [26,27]. We observed these 2 clinical features more often in patients with abnormal MTWA, though only pulmonary hypertension was confirmed to increase the probability of this phenomenon.…”

Increase in N-Terminus-Pro-B-Type Natriuretic Peptide During Exercise of Patients With Univentricular Heart After a Total Cavopulmonary Connection

“…This holds true for both systolic and diastolic heart failure and is independent of its cause. It also has been shown in many patients with congenital heart defects [5,22,25,35], including those with a univentricular heart and Fontan circulation [23,26].In acquired heart disease, an increase in N-terminus pro-B-type natriuretic peptide (NT-proBNP) during exercise was found related to transient myocardial ischemia [34], the size of a myocardial scar in coronary artery disease [29], and myocardial dysfunction [21,27,36]. However, a more recent report challenged these results because an NTproBNP increase during exercise was related primarily to the level at baseline in a multiple regression analysis [30].…”

“…This holds true for both systolic and diastolic heart failure and is independent of its cause. It also has been shown in many patients with congenital heart defects [5,22,25,35], including those with a univentricular heart and Fontan circulation [23,26].…”

Congenital Heart Disease and Pulmonary Hypertension

“…Endothelin-1 is a potent vasoconstrictor that can cause smooth muscle proliferation as well, leading to vascular remodeling. Circulating endothelin levels have been found to correlatewith disease severity and outcome in idiopathic PH, [40][41][42] although this mediator has been less extensively studied in Eisenmenger syndrome. 16,[43][44][45] The pulmonary endothelium is a major producer of NO.…”