Chest
Clinical InvestigationsPlasma N-Terminal Pro-Brain Natriuretic Peptide as a Marker of Right Ventricular Dysfunction in Patients With Tetralogy of Fallot After Surgical Repair
Section snippets
Study Population
We performed a prospectively designed detailed assessment of clinical and neurohormonal variables in 50 adult patients with TOF (26 women and 24 men) > 20 years after surgical repair. Patients were consecutively recruited from the specialized ACHD outpatient clinic of the Georg-August-University of Göttingen between January 2001 and September 2003. All the tests for each patient were carried out on the same day. One hundred age- and sex-matched healthy blood donors served as a control group for
Clinical Variables
The clinical and demographic characteristics of the 50 patients included in this study are given in Table 1. Age at operation, current age, and follow-up after operation in both groups (male and female) were similar. Ninety-six percent of male patients and 89% of female patients were classified as NYHA functional class I, and the rest were classified as NYHA functional class II. Sixty-eight percent of male and 57% of female patients underwent palliative procedures before surgical repair
Discussion
Most long-term follow-up studies in patients with TOF after cardiac surgery reveal good results of corrective repair.118192021 In Germany, the survival rate 20 years and 30 years after surgical repair is estimated to be 94% and 89%, respectively.2 However, the success of surgery depends also on the remaining morbidity of the surviving patients. Since the investigated patient group shows residual defects such as pulmonary stenosis, PR, and often tricuspid regurgitation, long-term RV pressure and
Conclusion
In 50 adults with TOF after corrective surgery, the cardiopulmonary capacity ( o2 max) and neurohormonal activities were determined, and hemodynamic status was evaluated by two-dimensional echocardiography. The patients showed reduced o2 max, elevated NT-proBNP, and increased RV size and systolic pressure. LV size and pump function were normal. Between o2 max and NT-proBNP, there was a significant inverse correlation. We found also a correlation between RV size,
ACKNOWLEDGMENT
We thank our study nurse Barbara Formanek, and Renate Lucyga, Ursula Baumgarten, and Sabine Laurenzano for technical assistance; and Talāt Mesud Yelbuz, MD, PhD, for critical reading of the manuscript and suggestions for improvement.
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