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May 25, 2026Journal of Family Medicine and Primary Care0 citationsOpen Access

NT-proBNP and hs-CRP may be useful biomarkers for identifying and stratifying repaired TOF patients at increased risk of RV systolic dysfunction

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AĐAda ĐozićEBEdin BegićNMNejra Mlačo

Key Result

NT-proBNP and hs-CRP levels were significantly inversely correlated with right ventricular fractional area change (r=-0.55, P=0.001 and r=-0.58, P<0.001) in adults with repaired Tetralogy of Fallot.

Key Points

  • This research aims to explore the relationship between inflammatory markers, volume overload, and echocardiographic findings in patients with repaired TOF.
  • Included 32 adult patients who underwent surgical correction of TOF during infancy.
  • Conducted transthoracic echocardiography and laboratory assessments of NT-proBNP and hs-CRP levels.
  • Correlated biomarker levels with echocardiographic parameters of the right heart.
  • NT-proBNP showed significant correlation with RV fractional area change (FAC) (r = -0.55, P = 0.001).
  • hs-CRP also correlated strongly with RV FAC (r = -0.58, P < 0.001).
  • A decrease of 10 units in NT-proBNP was linked to a 17% lower likelihood of RV FAC <35% (P = 0.017).

Study Design

Type

Observational (n=32)

Structured PICO

Do NT-proBNP and hs-CRP levels correlate with echocardiographic parameters of right ventricular dysfunction in adults with repaired Tetralogy of Fallot?

P
Population
32 adult patients (mean age 27.44 ± 6.22 years) with repaired Tetralogy of Fallot (rTOF) who underwent surgical correction during infancy.
O
Outcome
Correlation between NT-proBNP and hs-CRP levels and echocardiographic parameters of the right heart cavities (RV FAC, TAPSE, RV basal diameter, RA area)surrogate

NT-proBNP and hs-CRP levels significantly correlate with right ventricular systolic dysfunction in adults with repaired Tetralogy of Fallot, suggesting their utility as biomarkers for risk stratification.

Main Result

Effect estimate: r = -0.55 (NT-proBNP); r = -0.58 (hs-CRP)

p-value: p=0.001 (NT-proBNP); <0.001 (hs-CRP)

Abstract

A BSTRACT Introduction: Repaired TOF (rTOF) is a common condition in adult congenital heart disease care. The aim of this article is to investigate how inflammatory markers and volume overload affect rTOF, and how these factors correlate with echocardiographic findings in the right heart cavities. Methods: This study included 32 adult patients (mean age, 27.44 ± 6.22 years) who had undergone surgical correction of TOF during infancy. All participants underwent transthoracic echocardiography, and laboratory assessments included measurements of N-terminal pro-B-type natriuretic peptide (NT-proBNP; reference range ≤125 pg/mL) and high-sensitivity C-reactive protein (hs-CRP; reference range ≤2.0 mg/L). Results: Significant correlations were found between NT-proBNP levels and right ventricular (RV) fractional area change (FAC) (r = −0.55, P = 0.001), tricuspid annular plane systolic excursion (TAPSE) (r = −0.35, P = 0.04), RV basal diameter (r = 0.47, P = 0.006), and right atrium (RA) area (r = 0.50, P = 0.003). Similarly, hs-CRP levels showed strong associations with RV FAC (r = −0.58, P < 0.001), TAPSE (r = −0.45, P = 0.009), RV basal diameter (r = 0.43, P = 0.01), and RA area (r = 0.43, P = 0.01). NT-proBNP had a significant impact ( P = 0.017; EXP B = 0.982) on RV FAC. A decrease of 10 units in NT-proBNP was associated with a 17% reduction likelihood of having RV FAC <35%. Conclusion: The proinflammatory response (hs-CRP) and volume load (NT-proBNP) are directly correlated with echocardiographic parameters of the right heart cavities in patients with rTOF, suggesting that patients may benefit from treatment with anti-inflammatory drugs, as well as medications targeting diastolic dysfunction.

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Cite This Study

Đozić et al. (2026) conducted an observational in Repaired Tetralogy of Fallot (rTOF) (n=32). NT-proBNP and hs-CRP was evaluated on Correlation of NT-proBNP and hs-CRP with right ventricular fractional area change (RV FAC) (r = -0.55 (NT-proBNP); r = -0.58 (hs-CRP), p=0.001 (NT-proBNP); <0.001 (hs-CRP)). NT-proBNP and hs-CRP levels were significantly inversely correlated with right ventricular fractional area change (r=-0.55, P=0.001 and r=-0.58, P<0.001) in adults with repaired Tetralogy of Fallot.

synapsesocial.com/papers/6a13e8680e02ee3982d3325ahttps://doi.org/10.4103/jfmpc.jfmpc_1935_25
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