Abstract 13563: N-terminal Probrain Natriuretic Peptide and its Relation With Cardiac Dysfunction in Adult Patients With Congenital Heart Disease
Introduction: Although life expectancy has improved dramatically, most patients with congenital heart disease (CHD) are at risk to develop late complications including heart failure. Early detection of cardiac dysfunction may play a pivotal role.
Objectives: The aim of this study was to determine the relation between echocardiography and NT-proBNP in adults with CHD to improve cardiac function assessment.
Methods: Extensive 2D-echocardiography and NT-proBNP measurements were performed on the same day in adult CHD patients. The included CHD were corrected atrial septal defect (ASD) and aortic coarctation (CoA), corrected and uncorrected aortic stenosis (AoS), tetralogy of Fallot (ToF), transposition of the great arteries corrected by Mustard surgery or arterial switch operation (ASO) and Fontan circulation.
Results: We included 475 patients (age 34±12 years, 57% male, 90% NYHA I). Median NT-proBNP was 15.1 [IQR 24.2] pmol/L (elevated in 53%). Highest NT-proBNP levels were observed in complex CHD, comprising Fontan circulation (36.1 [IQR 89.4] pmol/L) and Mustard correction (31.1 [IQR 34.2] pmol/L); lowest levels were seen in patients with CoA and ASO (7.3 [IQR 16.7], respectively 8.5 [IQR 10.1]pmol/L). The most important relations between NT-proBNP and echocardiographic parameters per diagnosis are summarized in table 1. NT-proBNP correlated with diastolic function in patients with AoS or CoA . In patients with a systemic RV, NT-proBNP mainly correlated with RV annulus and less with RV function. In ToF patients NT-proBNP was most strongly related to LV function and LA dimension.
Conclusion: In conclusion, NT-proBNP levels in adult CHD patients clearly differ per diagnosis, and are related to echocardiographic parameters. Disease-specific correlations contribute to the understanding of the main hemodynamic problems per specific diagnosis. Follow-up data is needed to elucidate the additional prognostic value for clinical outcomes.
- © 2013 by American Heart Association, Inc.