Journal Article

B-type natriuretic peptide levels in patients with functionally univentricular hearts after total cavopulmonary connection

Andreas M.E. Koch, Stefan Zink, Helmut Singer and Sven Dittrich

in European Journal of Heart Failure

Published on behalf of European Society of Cardiology

Volume 10, issue 1, pages 60-62
Published in print January 2008 | ISSN: 1388-9842
Published online January 2008 | e-ISSN: 1879-0844 | DOI: https://dx.doi.org/10.1016/j.ejheart.2007.11.001
B-type natriuretic peptide levels in patients with functionally univentricular hearts after total cavopulmonary connection

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Aims:

To assess plasma B-type natriuretic peptide (BNP) levels in patients with univentricular hearts late after volume unloading by total cavopulmonary connection (TCPC).

Methods:

Plasma BNP was measured by sandwich immunoassay in 67 patients after a modified Fontan procedure. BNP levels were compared with age and sex-specific normal values, clinical and echocardiographic data, and results of exercise testing.

Results:

BNP had a wide range of 5–290 pg/ml, but was normal in 81% of patients, and median BNP was only 13pg/ml. There was no difference between males and females, between patients with left or right ventricular morphology, and no correlation was found between BNP and age, post-operative follow-up period, maximum exercise capability, peak oxygen uptake, or blood oxygen saturation. New York Heart Association class I patients had lower BNP than class II patients (p=0.04). Plasma BNP concentration was positively correlated to the number of specific sequelae (r=0.59, p<0.001), and to severity of atrioventricular regurgitation (r=0.38, p=0.002). 5/13 patients with elevated BNP died during follow-up.

Conclusion:

BNP plasma concentration was normal in the majority of patients up to 15 years after TCPC. Elevated and increasing BNP levels were associated with increased morbidity and late mortality.

Keywords: BNP; Fontan; Sequelae; Total cavopulmonary anastomosis; Univentricular heart

Journal Article.  1241 words.  Illustrated.

Subjects: Cardiovascular Medicine

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