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N-Terminal Pro-Brain Natriuretic Peptide as a Marker in Follow-Up Patients with Tetralogy of Fallot After Total Correction

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Abstract

Patients with tetralogy of Fallot (TOF) after total correction usually have residual pulmonary regurgitation resulting in right ventricular (RV) dilatation and dysfunction. This study was performed to evaluate N-terminal pro-brain natriuretic peptide (NT-proBNP) in predicting RV dilatation and RV dysfunction in TOF after total correction. Twenty-one patients with TOF after total correction (12 males and 9 females, 12.06 ± 2.54 years old) underwent echocardiography, cardiac magnetic resonance imaging (MRI), and blood sampling for NT-proBNP. Mean time after total correction was 7.59 ± 2.30 years. From cardiac MRI study, mean right ventricular end diastolic volume index (RVEDVi) was 148.36 ± 64.50 ml/m2 and mean right ventricular ejection fraction (RVEF) was 35.50 ± 10.50%. Right ventricular dilatation was considered if RVEDVi was >108 ml/m2 and RV dysfunction was considered if RVEF was <40%. A plasma NT-proBNP level of 115 pg/ml was identified by receiver operating characteristic analysis in predicting RV dilatation and/or dysfunction. At this value, the sensitivity and specificity for predicting RV dilatation, RV dysfunction, and both RV dilatation and dysfunction were 71 and 100%, 71 and 71%, and 83 and 78%, respectively. In conclusion, plasma NT-proBNP level may be helpful in follow-up patients. Plasma NT-proBNP levels >115 pg/ml can be used as a marker in the detection of RV dilatation and dysfunction.

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Acknowledgments

This study was supported by a research grant from the Faculty of Medicine, Ramathibodi Hospital, Mahidol University. We thank Dr. Chusak Okartchroen and Dr. Sangkae Chamnanwanakit for statistic consultation. We also that Roche Diagnostics for providing NT-proBNP reagents.

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Correspondence to A. Khositseth.

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Presented at The Scientific Sessions, American Heart Association, Dallas, Texas, USA, November 2005.

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Khositseth, A., Manop, J., Khowsathit, P. et al. N-Terminal Pro-Brain Natriuretic Peptide as a Marker in Follow-Up Patients with Tetralogy of Fallot After Total Correction. Pediatr Cardiol 28, 333–338 (2007). https://doi.org/10.1007/s00246-006-0170-5

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  • DOI: https://doi.org/10.1007/s00246-006-0170-5

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