B-Type Natriuretic Peptide in Patients with Systemic Right Ventricle

OBJECTIVE: To examine the diagnostic value of B-type natriuretic peptide (BNP) in patients with systemic right ventricle. METHODS: Plasma BNP levels were measured in 48 outpatients with D-transposition of the great arteries after atrial switch procedure or congenitally corrected transposition of the great arteries. RESULTS: Plasma BNP was < or =20 pg/ml in 52% and <200 pg/ml in all patients, significantly higher in females compared to males (p = 0.004), and positively correlated with age (r = 0.3, p = 0.04). New York Heart Association class I patients had significantly lower BNP than class II patients (p = 0.03). A positive correlation was found between BNP and severity of tricuspid regurgitation (r = 0.5, p < 0.001). Plasma BNP was weakly, negatively correlated to maximum exercise capability, peak oxygen uptake, maximum heart rate during exercise testing and minimal heart rate in the 24-hour Holter monitoring. Additionally, BNP was negatively correlated with flow velocity across the pulmonary valve in patients with congenitally corrected transposition of the great arteries (r = -0.81, p = 0.03). CONCLUSION: Plasma BNP is normal in patients with systemic right ventricle, but increases with deterioration of clinical status and decreasing exercise capability. BNP is positively correlated with severity of tricuspid regurgitation, a prognostic factor for survival.