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Comparison of plasma B-type natriuretic peptide levels in single ventricle patients with systemic ventricle heart failure versus isolated cavopulmonary failure.
Am J Cardiol. 2006 Aug 15; 98(4):520-4.AJ

Abstract

The measurement of plasma B-type natriuretic peptide (BNP) has emerged as a useful biomarker of heart failure in patients with cardiomyopathy. The pathophysiology of heart failure in single ventricle (SV) circulation may be distinct from that of cardiomyopathies. A distinct pattern of BNP elevation in heart failure in the SV population was hypothesized: it is elevated in heart failure secondary to ventricular dysfunction but not in isolated cavopulmonary failure. BNP was measured prospectively in SV patients at catheterization (n = 22) and when assessing for heart failure (n = 11) (7 normal controls). Of 33 SV subjects (median age 62 months), 13 had aortopulmonary connections and 20 had cavopulmonary connections. Median and mean +/- SD BNP levels by shunt type were 184 and 754 +/- 1,086 pg/ml in the patients with aortopulmonary connections, 38 and 169 +/- 251 pg/ml in the patients with cavopulmonary connections, and 10 and 11 +/- 5 pg/ml in normal controls, respectively (p = 0.004). Median systemic ventricular end-diastolic pressure (8mm Hg, R = 0.45), mean pulmonary artery pressure (14.5 mm Hg, R = 0.62), and mean right atrial pressure (6.5 mm Hg, R = 0.54) were correlated with plasma BNP. SV subjects with symptomatic heart failure from dysfunctional systemic ventricles had median and mean +/- SD BNP levels of 378 and 714 +/- 912 pg/ml (n = 18) compared with patients with isolated failed Glenn or Fontan connections (19 and 23 +/- 16 pg/ml [n = 7, p = 0.001]) and those with no heart failure (22 and 22 +/- 12 pg/ml [n = 8, p = 0.001]). Excluding the group with cavopulmonary failure, the severity of heart failure from systemic ventricular dysfunction was associated with plasma BNP. In conclusion, plasma BNP is elevated in SV patients with systemic ventricular or left-sided cardiac failure. BNP is not elevated in patients missing a pulmonary ventricle with isolated cavopulmonary failure.

Authors+Show Affiliations

Doernbecher Children's Hospital, Oregon Health and Science University, Portland, Oregon, USA. lawy@ohsu.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16893709

Citation

Law, Yuk Ming, et al. "Comparison of Plasma B-type Natriuretic Peptide Levels in Single Ventricle Patients With Systemic Ventricle Heart Failure Versus Isolated Cavopulmonary Failure." The American Journal of Cardiology, vol. 98, no. 4, 2006, pp. 520-4.
Law YM, Ettedgui J, Beerman L, et al. Comparison of plasma B-type natriuretic peptide levels in single ventricle patients with systemic ventricle heart failure versus isolated cavopulmonary failure. Am J Cardiol. 2006;98(4):520-4.
Law, Y. M., Ettedgui, J., Beerman, L., Maisel, A., & Tofovic, S. (2006). Comparison of plasma B-type natriuretic peptide levels in single ventricle patients with systemic ventricle heart failure versus isolated cavopulmonary failure. The American Journal of Cardiology, 98(4), 520-4.
Law YM, et al. Comparison of Plasma B-type Natriuretic Peptide Levels in Single Ventricle Patients With Systemic Ventricle Heart Failure Versus Isolated Cavopulmonary Failure. Am J Cardiol. 2006 Aug 15;98(4):520-4. PubMed PMID: 16893709.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of plasma B-type natriuretic peptide levels in single ventricle patients with systemic ventricle heart failure versus isolated cavopulmonary failure. AU - Law,Yuk Ming, AU - Ettedgui,Jose, AU - Beerman,Lee, AU - Maisel,Alan, AU - Tofovic,Stevan, Y1 - 2006/06/27/ PY - 2005/12/30/received PY - 2006/02/27/revised PY - 2006/02/27/accepted PY - 2006/8/9/pubmed PY - 2006/9/22/medline PY - 2006/8/9/entrez SP - 520 EP - 4 JF - The American journal of cardiology JO - Am. J. Cardiol. VL - 98 IS - 4 N2 - The measurement of plasma B-type natriuretic peptide (BNP) has emerged as a useful biomarker of heart failure in patients with cardiomyopathy. The pathophysiology of heart failure in single ventricle (SV) circulation may be distinct from that of cardiomyopathies. A distinct pattern of BNP elevation in heart failure in the SV population was hypothesized: it is elevated in heart failure secondary to ventricular dysfunction but not in isolated cavopulmonary failure. BNP was measured prospectively in SV patients at catheterization (n = 22) and when assessing for heart failure (n = 11) (7 normal controls). Of 33 SV subjects (median age 62 months), 13 had aortopulmonary connections and 20 had cavopulmonary connections. Median and mean +/- SD BNP levels by shunt type were 184 and 754 +/- 1,086 pg/ml in the patients with aortopulmonary connections, 38 and 169 +/- 251 pg/ml in the patients with cavopulmonary connections, and 10 and 11 +/- 5 pg/ml in normal controls, respectively (p = 0.004). Median systemic ventricular end-diastolic pressure (8mm Hg, R = 0.45), mean pulmonary artery pressure (14.5 mm Hg, R = 0.62), and mean right atrial pressure (6.5 mm Hg, R = 0.54) were correlated with plasma BNP. SV subjects with symptomatic heart failure from dysfunctional systemic ventricles had median and mean +/- SD BNP levels of 378 and 714 +/- 912 pg/ml (n = 18) compared with patients with isolated failed Glenn or Fontan connections (19 and 23 +/- 16 pg/ml [n = 7, p = 0.001]) and those with no heart failure (22 and 22 +/- 12 pg/ml [n = 8, p = 0.001]). Excluding the group with cavopulmonary failure, the severity of heart failure from systemic ventricular dysfunction was associated with plasma BNP. In conclusion, plasma BNP is elevated in SV patients with systemic ventricular or left-sided cardiac failure. BNP is not elevated in patients missing a pulmonary ventricle with isolated cavopulmonary failure. SN - 0002-9149 UR - https://www.unboundmedicine.com/medline/citation/16893709/Comparison_of_plasma_B_type_natriuretic_peptide_levels_in_single_ventricle_patients_with_systemic_ventricle_heart_failure_versus_isolated_cavopulmonary_failure_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(06)00824-1 DB - PRIME DP - Unbound Medicine ER -