Association between N-terminal pro-brain natriuretic peptide and quality of life in adult patients with congenital heart disease.
OBJECTIVE
Advances in medical treatment have resulted in increased life expectancy in congenital heart disease. Consequently, the focus of management has shifted from reducing mortality to reducing long-term morbidity with the goal of improving quality of life. A predictor of quality of life might be N-terminal pro-brain natriuretic peptide, a well-established marker for heart failure. We aimed to determine the association between N-terminal pro-brain natriuretic peptide and quality of life in patients with congenital heart disease.


METHODS
We collected blood samples from consecutive patients who were initially operated between 1968 and 1980 (47.8% women; mean age 40.2±5.4 years). The 36-item Short-Form Health Survey was completed to assess subjective health status as a measure of quality of life. Analysis was performed for the entire group and for subgroups defined as simple versus complex congenital heart diseases. Median N-terminal pro-brain natriuretic peptide level was 15.2 pmol/L (overall range 1.3-299.3 pmol/L). N-terminal pro-brain natriuretic peptide levels were associated with the subdomain physical functioning (β=-0.074, p=0.031). This association remained significant after adjustment for age and sex (β=-0.071, p=0.038) and after adjustment for age, sex, body mass index, left ventricular function, and renal function (β=-0.069, p=0.048). In complex congenital heart disease, the association between N-terminal pro-brain natriuretic peptide and physical functioning remained significant in multivariable analysis (β=-0.076, p=0.046). No associations were found in the simple congenital heart disease group or on the other health status subdomains.


CONCLUSIONS
In adults operated for congenital heart disease, N-terminal pro-brain natriuretic peptide is associated with the subdomain physical, primarily in the complex subgroup.
1Department of Cardiology,Erasmus Medical Center,Rotterdam,The Netherlands.
John O
JO
Younge
1Department of Cardiology,Erasmus Medical Center,Rotterdam,The Netherlands.
Jannet A
JA
Eindhoven
3Department of Adolescent Psychiatry/Psychology,Erasmus Medical Center,Rotterdam,The Netherlands.
Elisabeth W M J
EW
Utens
1Department of Cardiology,Erasmus Medical Center,Rotterdam,The Netherlands.
Petra
P
Opić
1Department of Cardiology,Erasmus Medical Center,Rotterdam,The Netherlands.
Judith A A E
JA
Cuypers
1Department of Cardiology,Erasmus Medical Center,Rotterdam,The Netherlands.
Annemien E
AE
van den Bosch
1Department of Cardiology,Erasmus Medical Center,Rotterdam,The Netherlands.
Maarten
M
Witsenburg
1Department of Cardiology,Erasmus Medical Center,Rotterdam,The Netherlands.
Ron T
RT
van Domburg
2Department of Clinical Epidemiology,Erasmus Medical Center,Rotterdam,The Netherlands.
M G Myriam
MG
Hunink
1Department of Cardiology,Erasmus Medical Center,Rotterdam,The Netherlands.
Jolien W
JW
Roos-Hesselink
D000203:Activities of Daily Living; D000328:Adult; D015415:Biomarkers / Q000097:blood; D005260:Female; D006330:Heart Defects, Congenital / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
natriuretic peptides