Peripheral Venous Pressure And NT-proBNP Phenotypes as Surrogates for Invasive Fontan Haemodynamics in Adults

Abstract

We hypothesized that phenotyping patients using a combination of resting peripheral venous pressure (PVP) and N-terminal pro–brain natriuretic peptide (NT-proBNP) would predict invasive Fontan haemodynamics. Accordingly, 35 adults with a history of Fontan palliation were categorized into 3 groups according to PVP and NT-proBNP values: normal, ↑NT-proBNP (≥300 pg/dL) or ↑PVP (≥15 mm Hg), and ↑PVP+↑NT-proBNP. Those in the normal values group universally had normal resting pulmonary artery wedge and Fontan pressures, with a single patient having abnormal exercise values; conversely, all patients in the ↑PVP+↑NT-proBNP group had increased resting Fontan or pulmonary artery wedge pressures, with those in the ↑NT-proBNP or ↑PVP group constituting an intermediate group.