Usefulness of Exercise-Induced Changes in Plasma Levels of Brain Natriuretic Peptide in Predicting Right Ventricular Contractile Reserve After Repair of Tetralogy of Fallot
Elevated levels of brain natriuretic peptide (BNP) have been associated with ventricular dysfunction, and exercise tests have been used for assessing cardiac contractile reserve. We examined the relation between BNP and right ventricular (RV) contractile reserve during exercise in patients after rep...
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| Veröffentlicht in: | The American journal of cardiology 2005-06, Vol.95 (11), p.1338-1343 |
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| creator | Ishii, Haruka Harada, Kenji Toyono, Manatomo Tamura, Masamichi Takada, Goro |
| description | Elevated levels of brain natriuretic peptide (BNP) have been associated with ventricular dysfunction, and exercise tests have been used for assessing cardiac contractile reserve. We examined the relation between BNP and right ventricular (RV) contractile reserve during exercise in patients after repair of tetralogy of Fallot (TOF). A total of 45 patients, 26 of whom underwent repair of TOF at 2 to 3 years of age and 19 age-matched healthy children, were studied. Plasma levels of BNP were measured at baseline and at maximal exercise. Echocardiography combined with tissue Doppler imaging (TDI) was performed at rest and during supine bicycle submaximal exercise. The peak value of the first derivation of RV pressure (peak dP/dt) was measured by the continuous-wave Doppler method. The severity of pulmonary regurgitation (PR) (mild, moderate, or severe) was based on color Doppler findings. Plasma BNP levels were significantly higher in patients with TOF than in controls (44 ± 34 vs 6 ± 4 pg/ml, p |
| doi_str_mv | 10.1016/j.amjcard.2005.01.079 |
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We examined the relation between BNP and right ventricular (RV) contractile reserve during exercise in patients after repair of tetralogy of Fallot (TOF). A total of 45 patients, 26 of whom underwent repair of TOF at 2 to 3 years of age and 19 age-matched healthy children, were studied. Plasma levels of BNP were measured at baseline and at maximal exercise. Echocardiography combined with tissue Doppler imaging (TDI) was performed at rest and during supine bicycle submaximal exercise. The peak value of the first derivation of RV pressure (peak dP/dt) was measured by the continuous-wave Doppler method. The severity of pulmonary regurgitation (PR) (mild, moderate, or severe) was based on color Doppler findings. Plasma BNP levels were significantly higher in patients with TOF than in controls (44 ± 34 vs 6 ± 4 pg/ml, p <0.01). Exercise was associated with increased plasma BNP levels in both groups. A larger increment in BNP was noted in patients with TOF than in normal subjects (15 ± 12 vs 2 ± 2 pg/ml, p <0.01). The peak systolic myocardial velocity (Sa) and peak dP/dt values increased significantly in both groups during exercise; however, the magnitude of increase in both of these values was significantly less in patients with TOF than in controls (36 ± 19% vs 70 ± 19% and 42 ± 11% vs 81 ± 12%, respectively; p <0.01). There were significant correlations between the increment in BNP and changes in Sa and peak dP/dt values (r = −0.67 and −0.53, p <0.01, respectively), and the severity of PR (r = 0.74, p <0.01). Thus, exercise increases plasma levels of BNP, and greater increases are associated with impaired RV contractile reserve in patients with TOF with various degrees of PR.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2005.01.079</identifier><identifier>PMID: 15904640</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Biological and medical sciences ; Brain ; Cardiology ; Cardiology. Vascular system ; Child ; Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava ; Coronary vessels ; Echocardiography ; Exercise ; Exercise Test ; Heart ; Humans ; Medical sciences ; Myocardial Contraction - physiology ; Natriuretic Peptide, Brain - blood ; Observer Variation ; Peptides ; Plasma ; Radioimmunoassay ; Tetralogy of Fallot - blood ; Tetralogy of Fallot - physiopathology ; Tetralogy of Fallot - surgery ; Ventricular Function, Right - physiology</subject><ispartof>The American journal of cardiology, 2005-06, Vol.95 (11), p.1338-1343</ispartof><rights>2005 Excerpta Medica Inc.</rights><rights>2005 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. 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We examined the relation between BNP and right ventricular (RV) contractile reserve during exercise in patients after repair of tetralogy of Fallot (TOF). A total of 45 patients, 26 of whom underwent repair of TOF at 2 to 3 years of age and 19 age-matched healthy children, were studied. Plasma levels of BNP were measured at baseline and at maximal exercise. Echocardiography combined with tissue Doppler imaging (TDI) was performed at rest and during supine bicycle submaximal exercise. The peak value of the first derivation of RV pressure (peak dP/dt) was measured by the continuous-wave Doppler method. The severity of pulmonary regurgitation (PR) (mild, moderate, or severe) was based on color Doppler findings. Plasma BNP levels were significantly higher in patients with TOF than in controls (44 ± 34 vs 6 ± 4 pg/ml, p <0.01). Exercise was associated with increased plasma BNP levels in both groups. A larger increment in BNP was noted in patients with TOF than in normal subjects (15 ± 12 vs 2 ± 2 pg/ml, p <0.01). The peak systolic myocardial velocity (Sa) and peak dP/dt values increased significantly in both groups during exercise; however, the magnitude of increase in both of these values was significantly less in patients with TOF than in controls (36 ± 19% vs 70 ± 19% and 42 ± 11% vs 81 ± 12%, respectively; p <0.01). There were significant correlations between the increment in BNP and changes in Sa and peak dP/dt values (r = −0.67 and −0.53, p <0.01, respectively), and the severity of PR (r = 0.74, p <0.01). Thus, exercise increases plasma levels of BNP, and greater increases are associated with impaired RV contractile reserve in patients with TOF with various degrees of PR.</description><subject>Biological and medical sciences</subject><subject>Brain</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Child</subject><subject>Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava</subject><subject>Coronary vessels</subject><subject>Echocardiography</subject><subject>Exercise</subject><subject>Exercise Test</subject><subject>Heart</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Myocardial Contraction - physiology</subject><subject>Natriuretic Peptide, Brain - blood</subject><subject>Observer Variation</subject><subject>Peptides</subject><subject>Plasma</subject><subject>Radioimmunoassay</subject><subject>Tetralogy of Fallot - blood</subject><subject>Tetralogy of Fallot - physiopathology</subject><subject>Tetralogy of Fallot - surgery</subject><subject>Ventricular Function, Right - physiology</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkdFqFDEUhgdR7Lb6CEoQ7N2MySSZmVxJXVotLFpK623IJme2GbKZNcks9p18SLPdgYI3XuWc5Ds_J3xF8Y7gimDSfBoqtR20CqaqMeYVJhVuxYtiQbpWlEQQ-rJYYIzrUhAmTorTGIfcEsKb18UJ4QKzhuFF8ec-Qj85DzGisUeXvyFoG6G89mbSYNDyQfkNRGQ9unEqbhVawR7cE_wlqHz9XaVgpwDJanQDu2QNPNEBjNXJ-g26tZuHhH6Cz6CenApoOeZa5VcH6BYihD2giz5ByN1O2XBIv4OMuHHzeGiulHNjelO86pWL8HY-z4r7q8u75bdy9ePr9fJiVWrWNansOVNkjWnHOWuEajrN-vzfviYgOk6B0VYz6JuaGpMrA0aLdq0VrCkjBjg9K86Pubsw_pogJrm1UYNzysM4Rdm0HRU5MYMf_gGHcQo-7yZrimnDOCMZ4kdIhzHGAL3cBbtV4VESLA8u5SBnl_LgUmIis8s8934On9ZbMM9Ts7wMfJwBFbVyfVA-u3vmmo51hNHMfT5y2RvsLQQZtQWf9doAOkkz2v-s8heldsIA</recordid><startdate>20050601</startdate><enddate>20050601</enddate><creator>Ishii, Haruka</creator><creator>Harada, Kenji</creator><creator>Toyono, Manatomo</creator><creator>Tamura, Masamichi</creator><creator>Takada, Goro</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20050601</creationdate><title>Usefulness of Exercise-Induced Changes in Plasma Levels of Brain Natriuretic Peptide in Predicting Right Ventricular Contractile Reserve After Repair of Tetralogy of Fallot</title><author>Ishii, Haruka ; Harada, Kenji ; Toyono, Manatomo ; Tamura, Masamichi ; Takada, Goro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c486t-f54a1b03855469a68c4f904f21e9853e437c4ef623dd7c4dedc97bcaeb341de53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Biological and medical sciences</topic><topic>Brain</topic><topic>Cardiology</topic><topic>Cardiology. Vascular system</topic><topic>Child</topic><topic>Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava</topic><topic>Coronary vessels</topic><topic>Echocardiography</topic><topic>Exercise</topic><topic>Exercise Test</topic><topic>Heart</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Myocardial Contraction - physiology</topic><topic>Natriuretic Peptide, Brain - blood</topic><topic>Observer Variation</topic><topic>Peptides</topic><topic>Plasma</topic><topic>Radioimmunoassay</topic><topic>Tetralogy of Fallot - blood</topic><topic>Tetralogy of Fallot - physiopathology</topic><topic>Tetralogy of Fallot - surgery</topic><topic>Ventricular Function, Right - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ishii, Haruka</creatorcontrib><creatorcontrib>Harada, Kenji</creatorcontrib><creatorcontrib>Toyono, Manatomo</creatorcontrib><creatorcontrib>Tamura, Masamichi</creatorcontrib><creatorcontrib>Takada, Goro</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ishii, Haruka</au><au>Harada, Kenji</au><au>Toyono, Manatomo</au><au>Tamura, Masamichi</au><au>Takada, Goro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Usefulness of Exercise-Induced Changes in Plasma Levels of Brain Natriuretic Peptide in Predicting Right Ventricular Contractile Reserve After Repair of Tetralogy of Fallot</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2005-06-01</date><risdate>2005</risdate><volume>95</volume><issue>11</issue><spage>1338</spage><epage>1343</epage><pages>1338-1343</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Elevated levels of brain natriuretic peptide (BNP) have been associated with ventricular dysfunction, and exercise tests have been used for assessing cardiac contractile reserve. We examined the relation between BNP and right ventricular (RV) contractile reserve during exercise in patients after repair of tetralogy of Fallot (TOF). A total of 45 patients, 26 of whom underwent repair of TOF at 2 to 3 years of age and 19 age-matched healthy children, were studied. Plasma levels of BNP were measured at baseline and at maximal exercise. Echocardiography combined with tissue Doppler imaging (TDI) was performed at rest and during supine bicycle submaximal exercise. The peak value of the first derivation of RV pressure (peak dP/dt) was measured by the continuous-wave Doppler method. The severity of pulmonary regurgitation (PR) (mild, moderate, or severe) was based on color Doppler findings. Plasma BNP levels were significantly higher in patients with TOF than in controls (44 ± 34 vs 6 ± 4 pg/ml, p <0.01). Exercise was associated with increased plasma BNP levels in both groups. A larger increment in BNP was noted in patients with TOF than in normal subjects (15 ± 12 vs 2 ± 2 pg/ml, p <0.01). The peak systolic myocardial velocity (Sa) and peak dP/dt values increased significantly in both groups during exercise; however, the magnitude of increase in both of these values was significantly less in patients with TOF than in controls (36 ± 19% vs 70 ± 19% and 42 ± 11% vs 81 ± 12%, respectively; p <0.01). There were significant correlations between the increment in BNP and changes in Sa and peak dP/dt values (r = −0.67 and −0.53, p <0.01, respectively), and the severity of PR (r = 0.74, p <0.01). Thus, exercise increases plasma levels of BNP, and greater increases are associated with impaired RV contractile reserve in patients with TOF with various degrees of PR.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>15904640</pmid><doi>10.1016/j.amjcard.2005.01.079</doi><tpages>6</tpages></addata></record> |
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| subjects | Biological and medical sciences Brain Cardiology Cardiology. Vascular system Child Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava Coronary vessels Echocardiography Exercise Exercise Test Heart Humans Medical sciences Myocardial Contraction - physiology Natriuretic Peptide, Brain - blood Observer Variation Peptides Plasma Radioimmunoassay Tetralogy of Fallot - blood Tetralogy of Fallot - physiopathology Tetralogy of Fallot - surgery Ventricular Function, Right - physiology |
| title | Usefulness of Exercise-Induced Changes in Plasma Levels of Brain Natriuretic Peptide in Predicting Right Ventricular Contractile Reserve After Repair of Tetralogy of Fallot |
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