Vnitr Lek 2007, 53(2):116-122

Residual echocardiographic findings and NT-proBNP in asymptomatic adult patients after radical correction of Fallot's tetralogy

T. Zatočil^*, J. Maňoušek, T. Brychta, A. Nečasová, J. Špinar

Interní kardiologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Jindřich Špinar, CSc., FESC

Objective:
Define the profile of NT-proBNP values in asymptomatic adult patients after radical correction of Tetralogy of Fallot (TOF) and identify links between possible increase in NT-proBNP and residual echocardiographic findings.

Methodology:
NT-proBNP samples were taken from and a detailed echocardiographic examination was performed in 21 adult stabilised patients after radical correction of TOF in childhood. The results were submitted for statistical analysis.

Results:
The incidence of low values of the S wave < 11.5 cm/s of tricuspid anulus evaluated by tissue Doppler echocardiography (TDI) (P < 0.05) was significantly higher in patients with NT-proBNP > 125 pg/ml. All patients with impaired right ventricular diastolic filling evaluated by tissue Doppler echocardiography (E' / A' < 1) had higher values of NT-proBNP (NS). Other echocardiographic parametres did not show any dependence on NT-proNBP values, including the morphology or atrial defects in the right heart sections which are most conspicuous in an echocardiographic examination.

Conclusion:
Asymptomatic patients after radical correction of TOF have higher values of NT-proBNP (167.95 ± 91.75 pg/ml). At the same time, the increase closely correlates with the detection of a global right ventricle systolic dysfunction evaluated by S (TDI). On the other hand, there is often no correlation between highly conspicuous changes in the morphology of the right heart compartments or residual or postincision defects of the pulmonary valve on the one hand and increased NT-proBNP on the other. The S measurement has the potential to become routine examination in patients after radical correction of TOF for timely detection of right ventricular systolic dysfunction. Precise prognostic and primarily therapeutic impact of the pathologic finding still needs to be determined.

Keywords: Fallot's tetralogy; tissue Doppler echocardiography; echocardiography; NT-proBNP

Received: May 24, 2006; Accepted: October 23, 2006; Published: February 1, 2007  Show citation