TY - JOUR
T1 - BNP and haematological parameters aremarkers of severity of Ebstein's anomaly
T2 - Correlation with CMR and cardiopulmonary exercise testing
AU - Hösch, Olga
AU - Ngyuen, Thuy Trang
AU - Lauerer, Peter
AU - Schuster, Andreas
AU - Kutty, Shelby
AU - Staab, Wieland
AU - Unterberg-Buchwald, Christina
AU - Sohns, Jan M.
AU - Paul, Thomas
AU - Lotz, Joachim
AU - Steinmetz, Michael
N1 - Publisher Copyright:
© 2015 The Author.
PY - 2015
Y1 - 2015
N2 - Aims Ebstein's anomaly (EA) involves a displaced and dysplastic tricuspid valve resulting in an atrialized portion of the right ventricle and an enlargement of the functional right ventricle and right atrium. Biomarkers targeting heart failure such as brain natriuretic peptide (BNP) or haematological parameters [haemoglobin (Hb) and haematocrit (Hct)] are upregulated in states of pulmonary hypoperfusion.We hypothesized that decreased pulmonary perfusion dependent on the stage of right heart failure is a possible mechanism in EA, and that it can be correlated with cardiac magnetic resonance (CMR) parameters. The aim of this study was to investigate the relationship between BNP and haematological parameters with functional parameters from CMR and exercise testing in patients with EA. Methods and results Twenty-five patients with non-corrected EA were studied prospectively (mean age 26±14 years). BNP level was increased (74±127 ng/L), and in 16% markedly above the heart failure cut-off level of 100 ng/L. Hb and Hct were increased above normal levels in 20 and 24% of patients, respectively. BNP and Hct/Hb correlated with CMR [total right/left (R/L)-Volume-Index, right atrium-end-diastolic volume index (EDVi), functional right ventricle (fRV)-EDVi, fRV-ejection fraction (EF), tricuspid regurgitation, pulmonary artery flow, and left ventricular EF] and exercise testing [workload/kg, oxygen uptake (VO2), ventilatory response to carbon dioxide production (VE/VCO2), oxygen (O2) pulse, and heart rate reserve]. The higher BNP and haematological parameters, the higher was the disease severity and the more limited was the physical exercise capacity. Conclusion In this EA cohort, BNP levels and haematological parameters correlatedwell with functional data fromCMRand exercise testing. The total R/L-Volume-Index andBNP, and to some extent hematological parameters, may be useful as prognostic markers in patients with EA.
AB - Aims Ebstein's anomaly (EA) involves a displaced and dysplastic tricuspid valve resulting in an atrialized portion of the right ventricle and an enlargement of the functional right ventricle and right atrium. Biomarkers targeting heart failure such as brain natriuretic peptide (BNP) or haematological parameters [haemoglobin (Hb) and haematocrit (Hct)] are upregulated in states of pulmonary hypoperfusion.We hypothesized that decreased pulmonary perfusion dependent on the stage of right heart failure is a possible mechanism in EA, and that it can be correlated with cardiac magnetic resonance (CMR) parameters. The aim of this study was to investigate the relationship between BNP and haematological parameters with functional parameters from CMR and exercise testing in patients with EA. Methods and results Twenty-five patients with non-corrected EA were studied prospectively (mean age 26±14 years). BNP level was increased (74±127 ng/L), and in 16% markedly above the heart failure cut-off level of 100 ng/L. Hb and Hct were increased above normal levels in 20 and 24% of patients, respectively. BNP and Hct/Hb correlated with CMR [total right/left (R/L)-Volume-Index, right atrium-end-diastolic volume index (EDVi), functional right ventricle (fRV)-EDVi, fRV-ejection fraction (EF), tricuspid regurgitation, pulmonary artery flow, and left ventricular EF] and exercise testing [workload/kg, oxygen uptake (VO2), ventilatory response to carbon dioxide production (VE/VCO2), oxygen (O2) pulse, and heart rate reserve]. The higher BNP and haematological parameters, the higher was the disease severity and the more limited was the physical exercise capacity. Conclusion In this EA cohort, BNP levels and haematological parameters correlatedwell with functional data fromCMRand exercise testing. The total R/L-Volume-Index andBNP, and to some extent hematological parameters, may be useful as prognostic markers in patients with EA.
KW - Brain natriuretic peptide
KW - Cardiopulmonary exercise testing
KW - Cardiovascular magnetic resonance imaging
KW - Ebstein's anomaly
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U2 - 10.1093/ehjci/jeu312
DO - 10.1093/ehjci/jeu312
M3 - Article
C2 - 25736309
AN - SCOPUS:84942116645
SN - 2047-2404
VL - 16
SP - 670
EP - 675
JO - European Heart Journal Cardiovascular Imaging
JF - European Heart Journal Cardiovascular Imaging
IS - 6
ER -