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NT-proBNP and exercise capacity in adult patients with congenital heart disease and a prosthetic valve: a multicentre PROSTAVA study
OBJECTIVES: N-terminal B‑type natriuretic peptide (NT-proBNP) is an important biomarker for the detection of heart failure. Adults with congenital heart disease (ACHD) and a prosthetic heart valve are at risk for heart failure. This study aimed to determine the value of NT-proBNP in ACHD patients wi...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Bohn Stafleu van Loghum
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5065538/ https://www.ncbi.nlm.nih.gov/pubmed/27620913 http://dx.doi.org/10.1007/s12471-016-0896-5 |
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author | Schoonbeek, R. C. Pieper, P. G. van Slooten, Y. J. Freling, H. G. Sieswerda, G. T. van Dijk, A. P. J. Jongbloed, M. R. M. Post, M. C. Bouma, B. J. Berger, R. M. F. Ebels, T. van Melle, J. P. |
author_facet | Schoonbeek, R. C. Pieper, P. G. van Slooten, Y. J. Freling, H. G. Sieswerda, G. T. van Dijk, A. P. J. Jongbloed, M. R. M. Post, M. C. Bouma, B. J. Berger, R. M. F. Ebels, T. van Melle, J. P. |
author_sort | Schoonbeek, R. C. |
collection | PubMed |
description | OBJECTIVES: N-terminal B‑type natriuretic peptide (NT-proBNP) is an important biomarker for the detection of heart failure. Adults with congenital heart disease (ACHD) and a prosthetic heart valve are at risk for heart failure. This study aimed to determine the value of NT-proBNP in ACHD patients with a prosthetic valve and investigate its relationship with cardiac function and exercise capacity. METHODS: In this multi-centre cross-sectional observational study, data regarding medical history, echocardiography, exercise testing (VO(2)peak) and laboratory blood evaluation (including NT-proBNP) were collected in ACHD patients with a single prosthetic valve (either homografts, heterografts or mechanical valves). RESULTS: A total of 306 ACHD patients with pulmonary valve replacement (PVR, n = 139), aortic valve replacement (n = 141), mitral valve replacement (n = 21) or tricuspid valve replacement (n = 5) were investigated. The majority of patients (77 %) were in NYHA class I or II. Elevated NT-proBNP levels (cut-off ≥125 pg/ml) were found in 50 % of the patients, with the highest levels in patients with mitral valve replacements. In this study population, NT-proBNP levels were associated with gender (p = 0.029) and VO(2)max (p < 0.001). In PVR patients, NT-proBNP levels were associated with lower VO(2)peak, also after adjustment for age, gender and age at valve replacement in a multivariate model (p = 0.015). CONCLUSIONS: In patients with ACHD and a prosthetic valve, elevated NT-proBNP levels are frequently observed despite preserved NYHA class. In PVR patients, a higher NT-proBNP level was associated with a lower VO(2)peak. These results may be of importance in the ongoing discussion about the timing of valve replacement in patients with CHD. |
format | Online Article Text |
id | pubmed-5065538 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Bohn Stafleu van Loghum |
record_format | MEDLINE/PubMed |
spelling | pubmed-50655382016-10-28 NT-proBNP and exercise capacity in adult patients with congenital heart disease and a prosthetic valve: a multicentre PROSTAVA study Schoonbeek, R. C. Pieper, P. G. van Slooten, Y. J. Freling, H. G. Sieswerda, G. T. van Dijk, A. P. J. Jongbloed, M. R. M. Post, M. C. Bouma, B. J. Berger, R. M. F. Ebels, T. van Melle, J. P. Neth Heart J Original Article OBJECTIVES: N-terminal B‑type natriuretic peptide (NT-proBNP) is an important biomarker for the detection of heart failure. Adults with congenital heart disease (ACHD) and a prosthetic heart valve are at risk for heart failure. This study aimed to determine the value of NT-proBNP in ACHD patients with a prosthetic valve and investigate its relationship with cardiac function and exercise capacity. METHODS: In this multi-centre cross-sectional observational study, data regarding medical history, echocardiography, exercise testing (VO(2)peak) and laboratory blood evaluation (including NT-proBNP) were collected in ACHD patients with a single prosthetic valve (either homografts, heterografts or mechanical valves). RESULTS: A total of 306 ACHD patients with pulmonary valve replacement (PVR, n = 139), aortic valve replacement (n = 141), mitral valve replacement (n = 21) or tricuspid valve replacement (n = 5) were investigated. The majority of patients (77 %) were in NYHA class I or II. Elevated NT-proBNP levels (cut-off ≥125 pg/ml) were found in 50 % of the patients, with the highest levels in patients with mitral valve replacements. In this study population, NT-proBNP levels were associated with gender (p = 0.029) and VO(2)max (p < 0.001). In PVR patients, NT-proBNP levels were associated with lower VO(2)peak, also after adjustment for age, gender and age at valve replacement in a multivariate model (p = 0.015). CONCLUSIONS: In patients with ACHD and a prosthetic valve, elevated NT-proBNP levels are frequently observed despite preserved NYHA class. In PVR patients, a higher NT-proBNP level was associated with a lower VO(2)peak. These results may be of importance in the ongoing discussion about the timing of valve replacement in patients with CHD. Bohn Stafleu van Loghum 2016-09-12 2016-11 /pmc/articles/PMC5065538/ /pubmed/27620913 http://dx.doi.org/10.1007/s12471-016-0896-5 Text en © The Author(s) 2016 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Original Article Schoonbeek, R. C. Pieper, P. G. van Slooten, Y. J. Freling, H. G. Sieswerda, G. T. van Dijk, A. P. J. Jongbloed, M. R. M. Post, M. C. Bouma, B. J. Berger, R. M. F. Ebels, T. van Melle, J. P. NT-proBNP and exercise capacity in adult patients with congenital heart disease and a prosthetic valve: a multicentre PROSTAVA study |
title | NT-proBNP and exercise capacity in adult patients with congenital heart disease and a prosthetic valve: a multicentre PROSTAVA study |
title_full | NT-proBNP and exercise capacity in adult patients with congenital heart disease and a prosthetic valve: a multicentre PROSTAVA study |
title_fullStr | NT-proBNP and exercise capacity in adult patients with congenital heart disease and a prosthetic valve: a multicentre PROSTAVA study |
title_full_unstemmed | NT-proBNP and exercise capacity in adult patients with congenital heart disease and a prosthetic valve: a multicentre PROSTAVA study |
title_short | NT-proBNP and exercise capacity in adult patients with congenital heart disease and a prosthetic valve: a multicentre PROSTAVA study |
title_sort | nt-probnp and exercise capacity in adult patients with congenital heart disease and a prosthetic valve: a multicentre prostava study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5065538/ https://www.ncbi.nlm.nih.gov/pubmed/27620913 http://dx.doi.org/10.1007/s12471-016-0896-5 |
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