Document Detail

Evaluation of right ventricular functions and B-type natriuretic peptide levels by cardiopulmonary exercise test in patients with pulmonary regurgitation after repair of tetralogy of Fallot.
MedLine Citation:
PMID:  18928486     Owner:  NLM     Status:  MEDLINE    
Impairment of right ventricular functions, especially due to chronic pulmonary regurgitation (PR), is a well-known entity in patients with tetralogy of Fallot (ToF) after repair. The aim of this study was to examine the relation between B-type natriuretic peptide (BNP) levels and right ventricular dysfunction by cardiopulmonary exercise test (ET) in patients after repair of ToF. Twenty-five patients with a mean age of 14.1 +/- 4.4 years at follow-up who underwent repair of ToF at a mean age of 4.9 +/- 5.1 years and 29 age- and sex-matched healthy children at a mean age of 13.1 +/- 2.8 years were enrolled in this study. Plasma BNP levels were measured at baseline and at maximal exercise. The volume of right ventricle (RV) and the degree of PR were assessed by two-dimensional echocardiography and color Doppler. Plasma BNP levels were significantly higher in patients with ToF than in controls (28.3 +/- 24.1 vs 7.4 +/- 2.3 pg/mL, p = 0.0001). Exercise was associated with increased plasma BNP levels in both groups. A greater increase in BNP was noted in patients with ToF than in controls (37.6 +/- 27.5 vs 11.3 +/- 4.5 pg/mL, p = 0.0001). Forced vital capacity (FVC%) (84.9 +/- 16.9 vs 98.4 +/- 18.2, p = 0.01) and forced expiratory volume during the 1st second (FEV1%) (91.5 +/- 19.3 vs 103.8 +/- 16.1, p = 0.02) were decreased, exercise duration (ED) (10.1 +/- 1.9 vs 11.4 +/- 1.7 min, p = 0.02), maximum heart rate (HRmax) (171.2 +/- 18.9 vs 186.4 +/- 13.9 /min, p = 0.004), and maximum oxygen uptake (VO(2)max) (1.56 +/- 0.53 vs 2.1 +/- 0.6 L/min, p = 0.007) were lower in patients with ToF. There were significant correlations between the degree of PR and ED (r =-0.3, p = 0.009), HRmax (r =-0.4, p = 0.001), and VO(2)max (r =-0.4, p = 0.001). The correlations were significant both before and after exercise, being more pronounced after exercise between BNP level and the degree of PR (r = 0.6, p = 0.0001). As a result, the severity of PR has a negative influence on right ventricular functions and there is significant relation between right ventricular functions and exercise capacity after repair of tetralogy of Fallot.
Ilker Cetin; Kürşad Tokel; Birgül Varan; Utku Arman Orün; Mahmut Gökdemir; Nimet Cindik; Füsun Eyüboğlu; Gaye Ulubay; Sait Aşlamaci
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  23     ISSN:  1540-8191     ISO Abbreviation:  J Card Surg     Publication Date:    2008 Sep-Oct
Date Detail:
Created Date:  2008-10-20     Completed Date:  2009-03-03     Revised Date:  2009-08-18    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  493-8     Citation Subset:  IM    
Division of Pediatric Cardiology, Department of Pediatrics, Başkent University Hospital, Ankara, Turkey.
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MeSH Terms
Cardiovascular Surgical Procedures / adverse effects*
Chronic Disease
Exercise Test*
Forced Expiratory Volume
Natriuretic Peptide, Brain / blood*
Oxygen Consumption
Prospective Studies
Pulmonary Valve / pathology*,  ultrasonography
Pulmonary Valve Insufficiency / blood,  etiology*,  pathology,  ultrasonography
Sensitivity and Specificity
Tetralogy of Fallot / blood,  physiopathology,  surgery*
Time Factors
Ventricular Dysfunction, Right / blood,  drug therapy*,  pathology,  ultrasonography
Vital Capacity
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain
Erratum In:
J Card Surg. 2009 May-Jun;24(3):359-61

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