Document Detail


The relationship of systemic right ventricular function to ECG parameters and NT-proBNP levels in adults with transposition of the great arteries late after Senning or Mustard surgery.
MedLine Citation:
PMID:  20720248     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
AIMS: Heart failure is common late after Senning or Mustard palliation of transposition of the great arteries (TGA). Although cardiac magnetic resonance (CMR) is the gold standard for evaluating systemic right ventricular performance, additional information regarding heart failure status might be gleaned from the surface ECG and circulating N-terminal pro-brain natriuretic peptide (NT-proBNP) levels. The interrelationships between these heart failure markers were examined in adults late after Mustard and Senning surgery.
METHODS: Thirty-five consecutive adults with Senning or Mustard repair of TGA attending a dedicated congenital heart failure clinic were studied. Assessment included symptom assessment, venous blood sampling for measurement of circulating NT-proBNP levels, surface 12-lead ECG and CMR for the assessment of right ventricular systolic function and determination of indexed right ventricular volumes.
RESULTS: Mean age was 29 ± 6.5 years, 54% had undergone Mustard surgery. Compared with those with uncomplicated surgery, patients with complex surgical history had higher NT-proBNP levels (55 ± 26 vs 20 ± 35 pmol/l; p=0.002) and longer QRS duration (116 ± 28 ms vs 89 ± 11 ms; p=0.0004) while showing no difference in New York Heart Association class and right ventricular function. There was a significant relationship between diastolic and systolic right ventricular volumes and both NT-proBNP levels (r=0.43, p=0.01; r=0.53, p=0.001, respectively) and QRS duration (r=0.47, p=0.004; r=0.53, p=0.001, respectively).
CONCLUSIONS: Circulating NT-proBNP levels and several surface ECG parameters constitute safe, cost-effective and widely available surrogate markers of systemic right ventricular function and provide additional information on heart failure status. Both measures hold promise as prognostic markers and their association with long-term outcome should be determined.
Authors:
Carla M Plymen; Marina L Hughes; Nathalie Picaut; Vasileios F Panoulas; Simon T Macdonald; Seamus Cullen; John E Deanfield; Fiona Walker; Andrew M Taylor; Pier D Lambiase; Aidan P Bolger
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-08-18
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  96     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  1569-73     Citation Subset:  AIM; IM    
Affiliation:
The Division of Adult Congenital Heart Disease, The Heart Hospital, University CollegeLondon Hospitals NHS Foundation Trust, London, UK. carla.plymen@uclh.nhs.uk
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MeSH Terms
Descriptor/Qualifier:
Grant Support
ID/Acronym/Agency:
//British Heart Foundation

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