title: Reduced contractile reserve of the systemic right ventricle under Dobutamine stress is associated with increased brain natriuretic peptide levels in patients with complete transposition after atrial repair.
abstract: OBJECTIVE
  To compare B-type natriuretic peptide (BNP) levels with response of systemic right ventricular function to Dobutamine stress.
  
  
  RESULTS
  Sixteen patients aged 25.6 +/- 3.7 years (eight each after Senning or Mustard repair of complete transposition) were studied. Transoesophageal imaging was performed in the catheterization laboratory under general anaesthesia before and at the end of a 10 min infusion of 5 microg/kg/min of Dobutamine. The BNP levels were measured at rest. Myocardial Doppler data were acquired before and at peak stress in a four-chamber view. The BNP (pg/mL) values of 67.3 +/- 47.5 (14-189) were elevated. There was no correlation between BNP and IVA, strain, or systolic and diastolic velocities at rest. Dobutamine stress led to a significant increase in IVA, s-velocity, and strain but no significant change in e-velocity. A correlation was found between increase in IVA under Dobutamine and BNP levels (r = 0.57, P < 0.02).
  
  
  CONCLUSIONS
  Elevated BNP levels correlate with response of systolic right ventricular function assessed by IVA to Dobutamine stress.
authors.affiliation: Department Pediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, München, Germany.
authors.forename: Manfred
authors.initials: M
authors.lastname: Vogt
authors.forename: Andreas
authors.initials: A
authors.lastname: Kühn
authors.forename: Johanna
authors.initials: J
authors.lastname: Wiese
authors.forename: Andreas
authors.initials: A
authors.lastname: Eicken
authors.forename: John
authors.initials: J
authors.lastname: Hess
authors.forename: Michael
authors.initials: M
authors.lastname: Vogel
mesh_terms: D000293:Adolescent; D002316:Cardiotonic Agents / Q000494:pharmacology; D004280:Dobutamine / Q000494:pharmacology; D025401:Echocardiography, Stress; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D009200:Myocardial Contraction / Q000502:physiology*; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D014188:Transposition of Great Vessels / Q000601:surgery; D018497:Ventricular Dysfunction, Right / Q000097:blood* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D055815:Young Adult
chemical_list: D002316:Cardiotonic Agents; D020097:Natriuretic Peptide, Brain; D004280:Dobutamine