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Right ventricular function in grown-up patients after correction of congenital right heart disease

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Abstract

Aims

We investigated whether a correlation exists between biomarkers of the neurohumoral system and clinical markers in grown-up patients with congenital heart disease (GUCH) and right ventricular function.

Methods and results

Prospective, cross-sectional, multicenter study of 104 GUCH patients (median) 16 years (range 6–43 years) after corrective surgery with RV pressure and/or volume overload and 54 healthy controls. Clinical, functional, and laboratory parameters were assessed. Natriuretic peptide levels were significantly increased in GUCH patients (NTproBNP 101 vs. 25 pg/ml, p < 0.001), but we observed no differences in norepinephrine, aldosterone, angiotensin II and Endothelin-1 levels. NTproBNP correlated significantly with clinical markers such as NYHA classification, prolonged QRS duration and reduced exercise capacity (VO2 peak) (all p < 0.001), as well as self-reported quality of life (p < 0.001). MRI and echocardiography derived RV volumes were elevated and ejection fraction reduced in the patients (both p < 0.001). Tissue Doppler parameter showed significantly restricted ventricular longitudinal systolic function (longitudinal tricuspid valve movement, 1.7 vs. 2.3 cm, p < 0.001), suggesting stiffness and reduced RV compliance.

Conclusion

In conclusion, grown-up patients with congenital right heart disease NTproBNP correlates well with various clinical markers of RV failure, such as prolongation of QRS duration, exercise capacity, echocardiography and MRI parameters, and quality of life.

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Acknowledgments

We are grateful to Ms. Altherr, University of Heidelberg, for measurement of the neurohumoral markers, Ms. Verena Materna, Coordination Center for Clinical Trials (KKS) Charité, Charite –Universitätsmedizin Berlin, Germany for the organizational support, Ms. Carole Cürten for proofreading. The work was supported by the Competence Network for Congenital Heart Defects founded by the Federal Ministry of Education and Research (BMBF), Bonn, Germany, FKZ 01G10210. The Clinical Trial Registration Information: Study ID Number: MP 5.1; 01G10210. Clinical Trials Gov. Identifier: NCT00266201.

Author information

Authors and Affiliations

  1. Deutsches Herzzentrum Berlin, Berlin, Germany

    Julia Lemmer, Grit Heise, Titus Kuehne & Brigitte Stiller

  2. Saarland University Hospital, Homburg, Germany

    Axel Rentzsch

  3. University Hospital Freiburg, Freiburg, Germany

    Petra Boettler & Brigitte Stiller

  4. German Heart Center Bad Oeynhausen, Bad Oeynhausen, Germany

    Karl Otto Dubowy

  5. University Hospital Magdeburg, Magdeburg, Germany

    Brigitte Peters

  6. Institute of Experimental and Clinical Pharmacology Heidelberg, Mannheim, Germany

    Bjoern Lemmer

  7. Deutsches Herzzentrum Muenchen, Munich, Germany

    Julia Lemmer & Alfred Hager

  8. Department of Pediatric Cardiology/Congenital Heart Defects, Deutsches Herzzentrum München, Technische Universität München, Lazarettstr. 36, 80636, Munich, Germany

    Julia Lemmer

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  1. Julia Lemmer
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Correspondence to Julia Lemmer.

Appendix

Appendix

This clinical trial was conducted with the collaboration of the Coordination Center for Clinical Trials (KKS) Charité, Charite –Universitätsmedizin Berlin, Germany.

The following institutions are members of the German Competence Network for Congenital Heart Defects. Participating centers (listed in order of the number of infants enrolled) include Deutsches Herzzentrum Berlin, Berlin—F. Berger, G. Heise; German Children’s Heart Center St. Augustin—M. Schneider, M. Kaestner; Heart and Diabetes Center Bad Oeynhausen—D. Kececioglu, S. Sarikouch, P. Beerbaum; Olga Hospital, Stuttgart—F. Uhlemann, C. Apitz, T. Eberle; University Hospital Eppendorf, Hamburg—J.Weil, T. Mir; Hospital Oldenburg—R. Motz; Albert-Ludwigs-University, Freiburg—J. Grohmann; Charité Humboldt University, Berlin—F. Berger, L. Schmitz; University Hospital Essen—A. A. Schmaltz; Tübingen—L. Sieverding, C. Apitz, Greil.

Consultant team in echocardiography H. Abdul-Khaliq (Saarland University Hospital), P. Boettler (Freiburg), M. Vogel (Munich), M. Vogt (Munich).

Consultant team in MRI S. Sarikouch (Bad Oeynhausen), P. Beerbaum (Bad Oeynhausen). M. Gutberlet (Berlin), T. Kuehne (Berlin)

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Lemmer, J., Heise, G., Rentzsch, A. et al. Right ventricular function in grown-up patients after correction of congenital right heart disease. Clin Res Cardiol 100, 289–296 (2011). https://doi.org/10.1007/s00392-010-0241-8

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  • DOI: https://doi.org/10.1007/s00392-010-0241-8

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