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.

Haberger, Stefanie; Hauser, Michael; Braun, Siegmund L; Schuster, Tibor; Ewert, Peter; Nagdyman, Nicole; Hess, John; Kaemmerer, Harald

doi:10.1253/circj.CJ-15-0348

2015

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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.
Document type:: Journal Article; Article
Author(s):: Haberger, Stefanie; Hauser, Michael; Braun, Siegmund L; Schuster, Tibor; Ewert, Peter; Nagdyman, Nicole; Hess, John; Kaemmerer, Harald
Abstract:: 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.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.BNP is a sensitive and specific prognostic marker for critical cardiac events after ASO. (Circ J 2015; 79: 2677-2681).
Journal title abbreviation:: Circ J
Year:: 2015
Journal volume:: 79
Journal issue:: 12
Pages contribution:: 2677-81
Language:: eng
Fulltext / DOI:: doi:10.1253/circj.CJ-15-0348
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/26376601
Print-ISSN:: 1346-9843
TUM Institution:: Institut für Laboratoriumsmedizin (keine SAP-Zuordnung!)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Lehr- und Forschungskooperationen mit den Kliniken und Instituten am Deutschen Herzzentrum Institut für Laboratoriumsmedizin (DHM) (Prof. Holdenrieder)2015