Abstract | BACKGROUND: Although surgical treatment for tetralogy of Fallot (TOF) has been used with considerable success, right ventricular function may remain altered after repair. The NT-proBNP assessment has been shown to be a reliable parameter for the heart failure assessment. AIM: To determine NT-proBNP values in assessment of right ventricular function in children after TOF correction. METHODS: In 20 patients after TOF correction aged from 10 to 17 years (follow-up period ranged from 7 to 16 years) NT-proBNP level at rest and after exertion, treadmill test and echocardiography were performed. In the control healthy children NT-proBNP level at rest was assessed. RESULTS: The mean values of NT-proBNP level in the TOF patients were significantly higher than in controls (11.0 +/- 12.0 fmol/l and 5.4 +/- 7.5 fmol/l, p < 0.05). In patients repaired with a transannular patch the mean value of NT-proBNP level was higher than in children operated on without a transannular patch (18.3 +/- 16.5 vs. 6.8 +/- 7.9 fmol/l, p < 0.05). In children in whom physiological shortening of QRS complex during treadmill test was observed, NT-proBNP level was lower (mean values at rest 5.0 +/- 4.8 fmol/l and after exertion 7.3 +/- 6.3 fmol/l) compared to patients with prolongation of QRS duration (mean values at rest 17.7 +/- 15.6 fmol/l and after exertion 20.3 +/- 17.8 fmol/l) (p < 0.05). Significant differences in NT-proBNP levels between children with severe pulmonary regurgitation and mild/moderate pulmonary regurgitation were detected (mean values at rest 18.6 +/- 15.0 vs. 4.2 +/- 3.9 fmol/l and after exertion 20.0 +/- 18.6 vs. 5.7 +/- 4.6 fmol/l) (p < 0.05). The NT-proBNP levels were also higher in children with severe tricuspid valve insufficiency compared to children with mild/moderate tricuspid valve regurgitation (mean values at rest 19.5 +/- 15.0 vs. 4.9 +/- 3.7 fmol/l and after exertion 22.5 +/- 17.1 vs. 7.0 +/- 4.6 fmol/l). CONCLUSIONS: The NT-proBNP level in patients after TOF correction is higher than in healthy children. The NT-proBNP level is higher and exertion tolerance is lower in children repaired with rather than without transannular patch. In patients with severe pulmonary regurgitation and/or severe tricuspid valve insufficiency NT-proBNP level is higher than in patients without right ventricular volume overload. The measurement of NT-proBNP level might be helpful in order to separate those patients after TOF correction who are at increased risk of heart failure and arrhythmia.
|
Authors | Radosław Pietrzak, Bozena Werner |
Journal | Kardiologia polska
(Kardiol Pol)
Vol. 67
Issue 4
Pg. 378-83
(Apr 2009)
ISSN: 0022-9032 [Print] Poland |
PMID | 19492250
(Publication Type: Controlled Clinical Trial, Journal Article)
|
Chemical References |
- Biomarkers
- Peptide Fragments
- pro-brain natriuretic peptide (1-76)
- Natriuretic Peptide, Brain
|
Topics |
- Adolescent
- Biomarkers
(metabolism)
- Cardiac Surgical Procedures
(adverse effects)
- Child
- Echocardiography
- Exercise Test
- Female
- Humans
- Male
- Natriuretic Peptide, Brain
(metabolism)
- Peptide Fragments
(metabolism)
- Pulmonary Valve Insufficiency
(diagnosis, etiology, metabolism)
- Pulmonary Valve Stenosis
(diagnosis, etiology, metabolism)
- Tetralogy of Fallot
(complications, surgery)
- Tricuspid Valve Insufficiency
(diagnosis, etiology, metabolism)
- Ventricular Dysfunction, Right
(diagnosis, etiology, metabolism)
|