Abstract 1977: Systemic Right Ventricular Function Late After Atrial Switch Redirection Surgery for Transposition of the Great Arteries Relates to NT-pro Brain Natriuretic Peptide and Electrocardiographic Parameters
Objectives: Left ventricular systolic function and heart failure events in adults with acquired heart failure relates to brain natriuretic peptide (NT-pro BNP) and surface ECG markers, including QRS duration. BNP is broadly associated with systemic ventricular function in congenital heart disease, but the relationship between BNP, QRS duration and systemic right ventricular function late after atrial switch redirection surgery for transposition of the great arteries is unknown. We conducted a prospective study to examine this.
Methods: Thirty-one consecutive adults with Senning or Mustard repair of transposition of the great arteries presenting to the outpatient department underwent cardiac MRI, NT-pro BNP measurement and 12 lead ECG.
Results: Mean age 29.6+/−6 years, 65% of patients were male, 55% and 45% had undergone Mustard and Senning procedure respectively. Mean age at palliation was 12+/−11 months. Mean NT-pro BNP was 40.9+/−35pmol/L, RVEDV 107.8+/−28ml/m2, RVESV 52.7+/−22ml/m2, RVEF 51.4+/−7%. There was a significant positive correlation between BNP and RVEDV (p=0.01, r=0.45) and RVESV (p=0.0009, r=0.58) and a significant negative correlation between BNP and RVEF (p<0.0001, r=0.69). Mean QRS duration was 95.7+/−22.ms, QTc 407+/−45ms. There was a significant correlation between RVEDV and QRS (p=0.0002, r=0.51) and QTc (p=0.007, r=0.38).
Conclusions: Late after atrial switch operation for transposition of the great arteries, measures of systemic right ventricular function relate to NT-pro BNP and surface ECG parameters, allowing further risk stratification. Their relationship to outcome requires further investigation.