title: N-terminal pro-brain natriuretic peptide as a marker in follow-up patients with tetralogy of Fallot after total correction.
abstract: Patients with tetralogy of Fallot (TOF) after total correction usually have residual pulmonary regurgitation resulting in right ventricular (RV) dilatation and dysfunction. This study was performed to evaluate N-terminal pro-brain natriuretic peptide (NT-proBNP) in predicting RV dilatation and RV dysfunction in TOF after total correction. Twenty-one patients with TOF after total correction (12 males and 9 females, 12.06 +/- 2.54 years old) underwent echocardiography, cardiac magnetic resonance imaging (MRI), and blood sampling for NT-proBNP. Mean time after total correction was 7.59 +/- 2.30 years. From cardiac MRI study, mean right ventricular end diastolic volume index (RVEDVi) was 148.36 +/- 64.50 ml/m2 and mean right ventricular ejection fraction (RVEF) was 35.50 +/- 10.50%. Right ventricular dilatation was considered if RVEDVi was >108 ml/m2 and RV dysfunction was considered if RVEF was <40%. A plasma NT-proBNP level of 115 pg/ml was identified by receiver operating characteristic analysis in predicting RV dilatation and/or dysfunction. At this value, the sensitivity and specificity for predicting RV dilatation, RV dysfunction, and both RV dilatation and dysfunction were 71 and 100%, 71 and 71%, and 83 and 78%, respectively. In conclusion, plasma NT-proBNP level may be helpful in follow-up patients. Plasma NT-proBNP levels >115 pg/ml can be used as a marker in the detection of RV dilatation and dysfunction.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, 10400 Phayathai, Bangkok, Thailand. alaks@diamond.mahidol.ac.th
authors.forename: A
authors.initials: A
authors.lastname: Khositseth
authors.forename: J
authors.initials: J
authors.lastname: Manop
authors.forename: P
authors.initials: P
authors.lastname: Khowsathit
authors.forename: S
authors.initials: S
authors.lastname: Siripornpitak
authors.forename: R
authors.initials: R
authors.lastname: Pornkul
authors.forename: P
authors.initials: P
authors.lastname: Lolekha
authors.forename: S
authors.initials: S
authors.lastname: Attanawanich
mesh_terms: D015415:Biomarkers / Q000097:blood*; D002648:Child; D004108:Dilatation, Pathologic; D005260:Female; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D013771:Tetralogy of Fallot / Q000601:surgery*; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis* / Q000209:etiology
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain