title: Tissue Doppler imaging and brain natriuretic peptide levels in adults with repaired tetralogy of Fallot.
abstract: BACKGROUND
  Accurate estimation of right ventricular (RV) function in patients with repaired tetralogy of Fallot (RTOF) is difficult, partly due to the presence of tricuspid regurgitation and pulmonary regurgitation and/or stenosis. The aim of the present study was to evaluate RV systolic and diastolic function of adult asymptomatic patients with RTOF by means of tissue Doppler imaging (TDI) and brain natriuretic peptide (BNP) values.
  
  
  METHODS
  25 adult patients with RTOF and 25 healthy controls were studied. The following echocardiographic measurements were obtained: RV diameter/left ventricular (LV) diameter (RVD/LVD) and systolic (Sa) and diastolic (Ea, Aa) velocities at the RV free wall tricuspid annulus site. Serum BNP levels were measured as well.
  
  
  RESULTS
  Patients with RTOF demonstrated reduced TDI velocities: Sa, 8.16 +/- 1.15 versus 16.43 +/- 1.15 cm/sec (P < .001); Ea, 10.00 +/- 2.18 versus 18.99 +/- 1.00 cm/sec (P < .001); Aa, 5.64 +/- 1.77 vs. 13.69 +/- 0.86 cm/sec (P < .001). Patients with RTOF also had higher BNP levels than controls (85.0 +/- 87.0 vs 5.36 +/- 1.0 pg/mL; P < .001). The increased BNP levels in RTOF patients correlated with the RVD/LVD ratio (r = .521; P < .01).
  
  
  CONCLUSIONS
  Our results indicate that although our cohort of patients was asymptomatic, using TDI and BNP allowed us to easily discriminate them from the healthy controls. The ability of TDI to assess ventricular function even in the presence of valvular lesions, as in RTOF patients, makes it a valuable tool in the investigation and follow-up of these patients.
authors.affiliation: Athens Medical School, Hippokration Hospital, Athens, Greece. nalexopolous@hotmail.com
authors.forename: Stella
authors.initials: S
authors.lastname: Brili
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Alexopoulos
authors.forename: Georgios
authors.initials: G
authors.lastname: Latsios
authors.forename: Constadina
authors.initials: C
authors.lastname: Aggeli
authors.forename: John
authors.initials: J
authors.lastname: Barbetseas
authors.forename: Christos
authors.initials: C
authors.lastname: Pitsavos
authors.forename: Gregory
authors.initials: G
authors.lastname: Vyssoulis
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
mesh_terms: D000293:Adolescent; D000328:Adult; D018619:Echocardiography, Doppler, Pulsed / Q000379:methods*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013771:Tetralogy of Fallot / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D016896:Treatment Outcome; D018497:Ventricular Dysfunction, Right / Q000097:blood* / Q000000981:diagnostic imaging* / Q000209:etiology / Q000517:prevention & control
chemical_list: D020097:Natriuretic Peptide, Brain