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.

Circ J. 2015 Nov 25;79(12):2677-81. doi: 10.1253/circj.CJ-15-0348. Epub 2015 Sep 16.

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

This is an interesting study on the prognostic value of plasma B-type natriuretic Peptide (BNP) in patients with a morphologic right systemic ventricle after atrial switch procedure. In a total of 89 patients, plasma BNP was determined during routine clinical follow-up examination. BNP was lower in patients with none or minimal symptoms (NYHA 1 or 2) when compared to patients with NYHA ≥3. During a median follow-up of 19 months, 8 patients experienced either decompensation, heart transplantation (n=3) or death (n=1). In univariate analysis, BNP was highly predictive for the endpoint (area under ROC curve: 0.90, p<0.001) and an optimal cut-off of 85pg/ml was found. Although these findings add to the appeal for BNP as prognostic biomarker in patients with a systemic RV, they need to be interpreted with caution. As only 8 patients experienced the primary event, the error margins are high and multivariable analysis to account for other variables could not be performed.  The prognostic value of BNP therefore needs to be confirmed in larger cohort studies.