Usefulness of serial N-terminal pro-B-type natriuretic peptide values after biventricular repair in patients with borderline hypoplastic left ventricle.
Takuya Osawa, Haonan Cheng, Jonas Palm, Carolin Niedermaier, Muneaki Matsubara, Thibault Schaeffer, Nicole Piber, Paul Philipp Heinisch, Christoph Röhlig, Alfred Hager, Peter Ewert, Jürgen Hörer, Masamichi Ono
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引用次数: 0
Abstract
Objectives: Biventricular repair for patients with borderline hypoplastic left ventricle is challenging, and a predictor of failing biventricular repair has not been clarified. This study aimed to analyze the z-log N-terminal pro-B-type natriuretic peptide and evaluate its usefulness in predicting outcomes after biventricular repair.
Methods: Patients who were diagnosed with borderline left heart hypoplasia and underwent biventricular repair from 2012 to 2022 were included. Serial N-terminal pro-B-type natriuretic peptide values were evaluated using its age-adjusted z-score. The data was collected from the first admission to the last follow-up, and compared between patients with failing biventricular repair (defined as death and haemodynamic failure) and patients with haemodynamically good biventricular outcomes.
Results: A total of 34 patients were included, and 7 patients (21%) developed adverse outcomes (5 deaths and 2 haemodynamic failure) following biventricular repair. The mean value of z-log N-terminal pro-B-type natriuretic peptide before biventricular repair was not significantly different between patients with failing biventricular repair and those without (2.2 [1.5-3.2] vs 3.3 [2.2-3.9], p = 0.200). However, patients with failing biventricular repair showed a continuous increase in N-terminal pro-B-type natriuretic peptide postoperatively. The value for patients with failing biventricular repair was higher within 7 days after BVR (p = 0.016) and at the last follow-up (p = 0.003) than those without. Postoperative z-log N-terminal pro-B-type natriuretic peptide and endocardial fibroelastosis at birth were identified as associated factors of failing biventricular repair.
Conclusions: Elevated z-log N-terminal pro-B-type natriuretic peptide after biventricular repair of borderline hypoplastic left ventricle seems to be a useful biomarker associated with poor outcomes.
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