title: Right ventricular function and N-terminal pro-brain natriuretic peptide levels in adult patients with simple dextro-transposition of the great arteries.
abstract: BACKGROUND
  Dextro-transposition of the great arteries (d-TGA) patients is at high risk of developing right ventricular dysfunction and tricuspid regurgitation in adulthood. Determining the relation between echocardiographic parameters, N-terminal pro-brain natriuretic peptide (NT-pro-BNP) levels and the New York Heart Association (NYHA) functional class may help determining the best time to operate them.
  
  
  METHODS
  Patients with simple d-TGA operated in infancy with an atrial switch procedure (Mustard or Senning operation) were followed up in our Adult Congenital Heart Disease Unit. Analytical, echocardiographic, and clinical parameters were determined to evaluate the correlation between right echocardiographic ventricular function, NT-pro-BNP levels, and NYHA functional class.
  
  
  RESULTS
  Twenty-four patients with d-TGA were operated in infancy of whom 17 alive patients had simple d-TGA. Nine patients had NT-pro-BNP levels lower than 200 pg/mL and eight patients were above 200 pg/mL. Patients with lower hemoglobin concentration, higher right ventricular diameter or under diuretic treatment showed significant higher NT-pro-BNP levels (above 200 pg/dL). The Spearman test showed a positive correlation between basal right ventricular diameter and tricuspid regurgitation with pro NT BNP levels (correlation coefficient of .624; P=.017 and .490; P=.046, respectively) and a negative correlation with the right ventricle fractional area change (-.508, P=.045). No correlation was seen between NT-pro-BNP levels and the rest of echocardiographic parameters or the NYHA functional class.
  
  
  CONCLUSIONS
  NT-pro-BNP levels showed a positive correlation with basal right ventricular diameter and tricuspid regurgitation but not with NYHA association functional class in d-TGA patients.
authors.affiliation: Cardiology Service, Insular-Materno Infantil University Hospital, Las Palmas de Gran Canaria, Spain.|Department of Medical and Surgical Sciences, Faculty of Health Sciences, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
authors.forename: Efrén
authors.identifier: http://orcid.org/0000-0002-1289-7279
authors.initials: E
authors.lastname: Martínez-Quintana
authors.affiliation: Cardiology Service, Insular-Materno Infantil University Hospital, Las Palmas de Gran Canaria, Spain.
authors.forename: Natalia
authors.initials: N
authors.lastname: Marrero-Negrín
authors.affiliation: Cardiology Service, Insular-Materno Infantil University Hospital, Las Palmas de Gran Canaria, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: Gopar-Gopar
authors.affiliation: Dr. Negrín University Hospital of Gran Canaria, Las Palmas de Gran Canaira, Spain.
authors.forename: Fayna
authors.initials: F
authors.lastname: Rodríguez-González
mesh_terms: D000328:Adult; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D014188:Transposition of Great Vessels / Q000097:blood* / Q000150:complications* / Q000000981:diagnostic imaging; D018497:Ventricular Dysfunction, Right / Q000150:complications* / Q000000981:diagnostic imaging*
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: congenital heart defects; dextro-transposition of the great arteries; myocardial performance index; right ventricular function; tissue doppler imaging; tricuspid annular plane systolic excursion; tricuspid regurgitation