B-type natriuretic peptide levels in patients with functionally univentricular hearts after total cavopulmonary connection.
OBJECTIVE
To assess plasma B-type natriuretic peptide (BNP) levels in patients with univentricular hearts late after volume unloading by total cavopulmonary connection (TCPC).


METHODS
Plasma BNP was measured by sandwich immunoassay in 67 patients after a modified Fontan procedure. BNP levels were compared with age and sex-specific normal values, clinical and echocardiographic data, and results of exercise testing.


RESULTS
BNP had a wide range of 5-290 pg/ml, but was normal in 81% of patients, and median BNP was only 13 pg/ml. There was no difference between males and females, between patients with left or right ventricular morphology, and no correlation was found between BNP and age, post-operative follow-up period, maximum exercise capability, peak oxygen uptake, or blood oxygen saturation. New York Heart Association class I patients had lower BNP than class II patients (p=0.04). Plasma BNP concentration was positively correlated to the number of specific sequelae (r=0.59, p<0.001), and to severity of atrioventricular regurgitation (r=0.38, p=0.002). 5/13 patients with elevated BNP died during follow-up.


CONCLUSIONS
BNP plasma concentration was normal in the majority of patients up to 15 years after TCPC. Elevated and increasing BNP levels were associated with increased morbidity and late mortality.
Koch
Andreas M E
AM
Department of Paediatric Cardiology, University of Erlangen-Nürnberg, Germany. Andreas.Koch@kinder.imed.uni-erlangen.de
Zink
Stefan
S
Singer
Helmut
H
Dittrich
Sven
S
D000293:Adolescent; D000328:Adult; D001022:Aortic Valve Insufficiency / Q000150:complications; D002648:Child; D002675:Child, Preschool; D005260:Female; D018729:Fontan Procedure / Q000379:methods* / Q000401:mortality; D006330:Heart Defects, Congenital / Q000097:blood* / Q000401:mortality / Q000601:surgery; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011651:Pulmonary Artery / Q000601:surgery; D012307:Risk Factors; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000601:surgery
D020097:Natriuretic Peptide, Brain