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Plasma brain natriuretic peptide levels, right ventricular volume overload and exercise capacity in adolescents after surgical repair of tetralogy of Fallot.
Int J Cardiol. 2007 Oct 01; 121(2):155-62.IJ

Abstract

BACKGROUND

Right ventricular (RV) volume overload secondary to pulmonary regurgitation contributes to long-term morbidities in patients after tetralogy of Fallot (TOF) repair. We tested the hypothesis that plasma brain natriuretic peptide (BNP) levels relate to RV volume overload, pulmonary regurgitation, and exercise capacity in adolescents after TOF repair.

METHODS

We assessed the RV function echocardiographically and plasma BNP levels in 32 postoperative TOF patients aged 14.7+/-3.1 years and 20 age-matched controls. Eighteen patients further underwent cardiovascular magnetic resonance imaging and 26 had exercise testing.

RESULTS

Compared with controls, patients had significantly higher BNP levels (p=0.027), greater indexed RV end-diastolic dimension (p<0.001), increased RV myocardial performance index (p=0.005), and reduced tricuspid annular systolic velocity (p=0.008). Multivariate analysis identified indexed RV end-diastolic dimension as the only significant determinant of plasma BNP levels (beta=0.69, p<0.001). Plasma BNP levels correlated positively with indexed RV end-diastolic volume (r=0.6, p=0.009) and pulmonary regurgitant fraction (r=0.54, p=0.026), and negatively with exercise duration (r=-0.45, p=0.021), peak oxygen consumption (r=-0.43, p=0.03), and minute ventilation at maximal exercise (r=-0.52, p=0.006). Multivariate analysis demonstrated BNP levels (beta=-0.43, p=0.034) and body mass index (beta=-0.40, p=0.036) to be independent predictors of peak oxygen consumption. No relations were found between BNP levels and RV myocardial performance index, tricuspid annular velocities and RV ejection fraction.

CONCLUSIONS

In adolescent patients after TOF repair, plasma BNP levels relate to RV volume overload, pulmonary regurgitation and exercise capacity.

Authors+Show Affiliations

Division of Paediatric Cardiology, Grantham Hospital, The University of Hong Kong, Hong Kong, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17182138

Citation

Cheung, Eddie W Y., et al. "Plasma Brain Natriuretic Peptide Levels, Right Ventricular Volume Overload and Exercise Capacity in Adolescents After Surgical Repair of Tetralogy of Fallot." International Journal of Cardiology, vol. 121, no. 2, 2007, pp. 155-62.
Cheung EW, Lam WW, Chiu CS, et al. Plasma brain natriuretic peptide levels, right ventricular volume overload and exercise capacity in adolescents after surgical repair of tetralogy of Fallot. Int J Cardiol. 2007;121(2):155-62.
Cheung, E. W., Lam, W. W., Chiu, C. S., Chau, A. K., Cheung, S. C., & Cheung, Y. F. (2007). Plasma brain natriuretic peptide levels, right ventricular volume overload and exercise capacity in adolescents after surgical repair of tetralogy of Fallot. International Journal of Cardiology, 121(2), 155-62.
Cheung EW, et al. Plasma Brain Natriuretic Peptide Levels, Right Ventricular Volume Overload and Exercise Capacity in Adolescents After Surgical Repair of Tetralogy of Fallot. Int J Cardiol. 2007 Oct 1;121(2):155-62. PubMed PMID: 17182138.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Plasma brain natriuretic peptide levels, right ventricular volume overload and exercise capacity in adolescents after surgical repair of tetralogy of Fallot. AU - Cheung,Eddie W Y, AU - Lam,Wendy W M, AU - Chiu,Clement S W, AU - Chau,Adolphus K T, AU - Cheung,Stephen C W, AU - Cheung,Yiu-fai, Y1 - 2006/12/19/ PY - 2006/08/22/received PY - 2006/10/21/accepted PY - 2006/12/22/pubmed PY - 2007/9/29/medline PY - 2006/12/22/entrez SP - 155 EP - 62 JF - International journal of cardiology JO - Int. J. Cardiol. VL - 121 IS - 2 N2 - BACKGROUND: Right ventricular (RV) volume overload secondary to pulmonary regurgitation contributes to long-term morbidities in patients after tetralogy of Fallot (TOF) repair. We tested the hypothesis that plasma brain natriuretic peptide (BNP) levels relate to RV volume overload, pulmonary regurgitation, and exercise capacity in adolescents after TOF repair. METHODS: We assessed the RV function echocardiographically and plasma BNP levels in 32 postoperative TOF patients aged 14.7+/-3.1 years and 20 age-matched controls. Eighteen patients further underwent cardiovascular magnetic resonance imaging and 26 had exercise testing. RESULTS: Compared with controls, patients had significantly higher BNP levels (p=0.027), greater indexed RV end-diastolic dimension (p<0.001), increased RV myocardial performance index (p=0.005), and reduced tricuspid annular systolic velocity (p=0.008). Multivariate analysis identified indexed RV end-diastolic dimension as the only significant determinant of plasma BNP levels (beta=0.69, p<0.001). Plasma BNP levels correlated positively with indexed RV end-diastolic volume (r=0.6, p=0.009) and pulmonary regurgitant fraction (r=0.54, p=0.026), and negatively with exercise duration (r=-0.45, p=0.021), peak oxygen consumption (r=-0.43, p=0.03), and minute ventilation at maximal exercise (r=-0.52, p=0.006). Multivariate analysis demonstrated BNP levels (beta=-0.43, p=0.034) and body mass index (beta=-0.40, p=0.036) to be independent predictors of peak oxygen consumption. No relations were found between BNP levels and RV myocardial performance index, tricuspid annular velocities and RV ejection fraction. CONCLUSIONS: In adolescent patients after TOF repair, plasma BNP levels relate to RV volume overload, pulmonary regurgitation and exercise capacity. SN - 1874-1754 UR - https://www.unboundmedicine.com/medline/citation/17182138/Plasma_brain_natriuretic_peptide_levels_right_ventricular_volume_overload_and_exercise_capacity_in_adolescents_after_surgical_repair_of_tetralogy_of_Fallot_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-5273(06)01379-9 DB - PRIME DP - Unbound Medicine ER -