What does this research mean for the field?

In pediatric and adolescent patients following the Fontan procedure, serum BNP levels remain within normal limits for the majority and show only weak associations with indicators of suboptimal clinical and ventricular outcomes. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

March 25, 2011Congenital Heart DiseaseOpen Access

Factors Associated with Serum Brain Natriuretic Peptide Levels after the Fontan Procedure

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Fontan circulation (n=510). Intervention: Clinical, demographic, and echocardiographic factors. Primary outcome: Distribution of brain natriuretic peptide (BNP) and factors associated with logBNP.

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Key result

BNP is typically normal after Fontan and correlates only weakly with suboptimal outcomes.

n=510

Why the study?

The utility of brain natriuretic peptide concentration (BNP) as a marker of heart failure in children after the Fontan procedure is not well studied.

Study Design

Type

Cross-Sectional (n=510)

Multicenter

Yes

PICO

Population

510 children and adolescents (mean age 11.9 years, 40% female) who had undergone the Fontan procedure at least 6 months prior, evaluated cross-sectionally at a median of 8.2 years post-procedure.

Exposure / Comparator

Clinical, demographic, and echocardiographic factors

Primary Outcome

Distribution of brain natriuretic peptide (BNP) and factors associated with logBNP

Limitations

Cross-sectional design cannot assess the predictive value of BNP for outcomes such as death or progressive heart failure.
The most symptomatic Fontan patients may not have been included since it was an outpatient cohort.
The rather narrow range of BNP values measured may have impeded efforts to find strong associations.
Not all patients were able to complete all tests, which might limit the ability to detect associations.

Discussion

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Implication

BNP should not guide management in pediatric Fontan patients; leaves open its prognostic value in prospective studies.

Cite This Study

Atz et al. (2011) conducted a cross-sectional in Fontan circulation (n=510). Clinical, demographic, and echocardiographic factors was evaluated on Distribution of brain natriuretic peptide (BNP) and factors associated with logBNP. In children and adolescents after the Fontan procedure, median BNP was 13.0 pg/mL (within normal range for most), and higher levels were only weakly associated with markers of suboptimal outcomes.

synapsesocial.com/papers/6ac6fd0c11717e620d6a23db https://doi.org/10.1111/j.1747-0803.2011.00496.x

Topics

Congenital heart disease adults

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Factors Associated with Serum Brain Natriuretic Peptide Levels after the Fontan Procedure

Study Design

PICO

Limitations

Discussion

Implication

Cite This Study

Topics

Factors Associated with Serum Brain Natriuretic Peptide Levels after the Fontan Procedure

Study Design

PICO

Limitations

Discussion

Implication

Cite This Study

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Topics

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