Document Detail

Plasma brain natriuretic peptide levels, right ventricular volume overload and exercise capacity in adolescents after surgical repair of tetralogy of Fallot.
MedLine Citation:
PMID:  17182138     Owner:  NLM     Status:  MEDLINE    
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.
Eddie W Y Cheung; Wendy W M Lam; Clement S W Chiu; Adolphus K T Chau; Stephen C W Cheung; Yiu-fai Cheung
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2006-12-19
Journal Detail:
Title:  International journal of cardiology     Volume:  121     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-09-07     Completed Date:  2007-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  155-62     Citation Subset:  IM    
Division of Paediatric Cardiology, Grantham Hospital, The University of Hong Kong, Hong Kong, China.
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MeSH Terms
Cohort Studies
Exercise Test* / methods
Natriuretic Peptide, Brain / blood*
Tetralogy of Fallot / blood*,  physiopathology,  surgery*
Ventricular Dysfunction, Right / blood*,  physiopathology,  surgery
Ventricular Function, Right / physiology
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain

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