Serial NT-proBNP levels were significantly associated with death/transplant in adults with Fontan palliation, outperforming single NT-proBNP measurements.
Does serial NT-proBNP measurement predict death or transplant in adults with Fontan palliation?
Serial NT-proBNP measurements provide superior prognostic value for predicting death or transplant in adults with Fontan palliation compared to single baseline measurements or standard imaging and hemodynamic indices.
Absolute Event Rate: 0% vs 0%
Background: There are limited data about the prognostic role of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in adults with Fontan palliation.The purpose of this study was to determine the correlates of, and the prognostic value of serial NT-proBNP assay for risk stratification in adults with Fontan palliation. Method:Retrospective cohort study of adults with Fontan palliation that had 1 NT-proBNP measurements in the outpatient clinic (2003-2023).In patients with 3 NT-proBNP measurements, serial NT-proBNP was calculated as the mean of the first 3 measurements.Study outcome was death/transplant. Results:Of 369 patients (age 278 years; 55% males) with NT-proBNP, 214 (58%) had serial measurements.The baseline level was 217 (82, 562) pg/ml while the serial value was 261 (98, 715) pg/ml.The correlates of higher NT-proBNP levels were older age, atriopulmonary connection, atrial fibrillation, hepatorenal dysfunction, systemic ventricular dilation and systolic dysfunction, and higher Fontan pressures and pulmonary artery wedge pressure.Baseline as well as serial NT-proBNP levels were associated with death/transplant independent of anatomic indices, comorbidities and hemodynamic indices.Serial NT-proBNP levels had superior prognostic value compared to single (baseline) NT-proBNP measurements, echocardiographic, cardiac magnetic resonance imaging indices, and cardiac catheterization indices.Conclusions: These findings have important clinical implications in the management of adults with Fontan palliation since NT-proBNP assay is inexpensive, readily available, and noninvasive, and hence ideal for longitudinal assessment.Further studies are J o u r n a l P r e -p r o o f required to determine whether NT-proBNP can be used as a surrogate marker to monitor response to therapeutic interventions in this population.
Abozied et al. (Sun,) reported a other. Serial NT-proBNP levels were significantly associated with death/transplant in adults with Fontan palliation, outperforming single NT-proBNP measurements.