title: Prognostic Value of Plasma B-Type Natriuretic Peptide in the Long-Term Follow-up of Patients With Transposition of the Great Arteries With Morphologic Right Systemic Ventricle After Atrial Switch Operation.
abstract: BACKGROUND
  B-type natriuretic peptide (BNP) is an established marker for heart failure assessment, but the prognostic quality of BNP after atrial switch operation (ASO) has not yet been elucidated.
  
  
  RESULTS
  In 89 patients (median age, 24 years; range, 15-35 years) after ASO, BNP was measured. During a 48-months follow-up we focused on critical cardiac events, defined as decompensation, sudden cardiac death or need for heart transplantation. BNP was considerably lower in 81 patients in functional class (FC) I/II (median, 35 pg/ml; range, 3-586 pg/ml) than in 6 patients in FC III/IV (median, 246 pg/ml; range, 14-1,150 pg/ml, P≤0.073). BNP was significantly higher after Mustard than after Senning procedure (P≤0.030). There was no significant difference in BNP between simple or complex transposition of the great arteries (TGA) (P≤0.44). Eleven subjects (13%, 95% CI: 7-22%) had a critical cardiac event within 48 months. On ROC analysis BNP had a high predictive value regarding discrimination of patients with and without critical events (area under the ROC curve, 0.90; 95% CI: 0.76 to >0.99, P<0.001). The cut-off was 85 pg/ml (sensitivity, 88%; specificity, 85%). Additionally, estimated event-free-survival was longer after Senning than after Mustard procedure (P≤0.017). There was no significant difference in outcome between patients with simple or complex TGA with regard to occurrence of critical events.
  
  
  CONCLUSIONS
  BNP is a sensitive and specific prognostic marker for critical cardiac events after ASO.
authors.affiliation: Department for Pediatric Cardiology and Congenital Heart Disease, German Heart Center.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Haberger
authors.forename: Michael
authors.initials: M
authors.lastname: Hauser
authors.forename: Siegmund L
authors.initials: SL
authors.lastname: Braun
authors.forename: Tibor
authors.initials: T
authors.lastname: Schuster
authors.forename: Peter
authors.initials: P
authors.lastname: Ewert
authors.forename: Nicole
authors.initials: N
authors.lastname: Nagdyman
authors.forename: John
authors.initials: J
authors.lastname: Hess
authors.forename: Harald
authors.initials: H
authors.lastname: Kaemmerer
mesh_terms: D000293:Adolescent; D000328:Adult; D006348:Cardiac Surgical Procedures; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D015996:Survival Rate; D014188:Transposition of Great Vessels / Q000097:blood / Q000401:mortality / Q000601:surgery
chemical_list: D020097:Natriuretic Peptide, Brain