BNP and haematological parameters aremarkers of severity of Ebstein's anomaly: Correlation with CMR and cardiopulmonary exercise testing

Olga Hösch, Thuy Trang Ngyuen, Peter Lauerer, Andreas Schuster, Shelby Kutty, Wieland Staab, Christina Unterberg-Buchwald, Jan M. Sohns, Thomas Paul, Joachim Lotz, Michael Steinmetz

Research output: Contribution to journalArticle

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Abstract

Aims Ebstein's anomaly (EA) involves a displaced and dysplastic tricuspid valve resulting in an atrialized portion of the right ventricle and an enlargement of the functional right ventricle and right atrium. Biomarkers targeting heart failure such as brain natriuretic peptide (BNP) or haematological parameters [haemoglobin (Hb) and haematocrit (Hct)] are upregulated in states of pulmonary hypoperfusion.We hypothesized that decreased pulmonary perfusion dependent on the stage of right heart failure is a possible mechanism in EA, and that it can be correlated with cardiac magnetic resonance (CMR) parameters. The aim of this study was to investigate the relationship between BNP and haematological parameters with functional parameters from CMR and exercise testing in patients with EA. Methods and results Twenty-five patients with non-corrected EA were studied prospectively (mean age 26±14 years). BNP level was increased (74±127 ng/L), and in 16% markedly above the heart failure cut-off level of 100 ng/L. Hb and Hct were increased above normal levels in 20 and 24% of patients, respectively. BNP and Hct/Hb correlated with CMR [total right/left (R/L)-Volume-Index, right atrium-end-diastolic volume index (EDVi), functional right ventricle (fRV)-EDVi, fRV-ejection fraction (EF), tricuspid regurgitation, pulmonary artery flow, and left ventricular EF] and exercise testing [workload/kg, oxygen uptake (VO2), ventilatory response to carbon dioxide production (VE/VCO2), oxygen (O2) pulse, and heart rate reserve]. The higher BNP and haematological parameters, the higher was the disease severity and the more limited was the physical exercise capacity. Conclusion In this EA cohort, BNP levels and haematological parameters correlatedwell with functional data fromCMRand exercise testing. The total R/L-Volume-Index andBNP, and to some extent hematological parameters, may be useful as prognostic markers in patients with EA.

Original languageEnglish (US)
Pages (from-to)670-675
Number of pages6
JournalEuropean heart journal cardiovascular Imaging
Volume16
Issue number6
DOIs
StatePublished - Jan 1 2015

Fingerprint

Ebstein Anomaly
Brain Natriuretic Peptide
Magnetic Resonance Spectroscopy
Exercise
Heart Ventricles
Hematocrit
Hemoglobins
Heart Failure
Heart Atria
Heart Rate
Oxygen
Tricuspid Valve Insufficiency
Lung
Tricuspid Valve
Workload
Carbon Dioxide
Stroke Volume
Pulmonary Artery
Perfusion
Biomarkers

Keywords

  • Brain natriuretic peptide
  • Cardiopulmonary exercise testing
  • Cardiovascular magnetic resonance imaging
  • Ebstein's anomaly

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

BNP and haematological parameters aremarkers of severity of Ebstein's anomaly : Correlation with CMR and cardiopulmonary exercise testing. / Hösch, Olga; Ngyuen, Thuy Trang; Lauerer, Peter; Schuster, Andreas; Kutty, Shelby; Staab, Wieland; Unterberg-Buchwald, Christina; Sohns, Jan M.; Paul, Thomas; Lotz, Joachim; Steinmetz, Michael.

In: European heart journal cardiovascular Imaging, Vol. 16, No. 6, 01.01.2015, p. 670-675.

Research output: Contribution to journalArticle

Hösch, O, Ngyuen, TT, Lauerer, P, Schuster, A, Kutty, S, Staab, W, Unterberg-Buchwald, C, Sohns, JM, Paul, T, Lotz, J & Steinmetz, M 2015, 'BNP and haematological parameters aremarkers of severity of Ebstein's anomaly: Correlation with CMR and cardiopulmonary exercise testing', European heart journal cardiovascular Imaging, vol. 16, no. 6, pp. 670-675. https://doi.org/10.1093/ehjci/jeu312
Hösch, Olga ; Ngyuen, Thuy Trang ; Lauerer, Peter ; Schuster, Andreas ; Kutty, Shelby ; Staab, Wieland ; Unterberg-Buchwald, Christina ; Sohns, Jan M. ; Paul, Thomas ; Lotz, Joachim ; Steinmetz, Michael. / BNP and haematological parameters aremarkers of severity of Ebstein's anomaly : Correlation with CMR and cardiopulmonary exercise testing. In: European heart journal cardiovascular Imaging. 2015 ; Vol. 16, No. 6. pp. 670-675.
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abstract = "Aims Ebstein's anomaly (EA) involves a displaced and dysplastic tricuspid valve resulting in an atrialized portion of the right ventricle and an enlargement of the functional right ventricle and right atrium. Biomarkers targeting heart failure such as brain natriuretic peptide (BNP) or haematological parameters [haemoglobin (Hb) and haematocrit (Hct)] are upregulated in states of pulmonary hypoperfusion.We hypothesized that decreased pulmonary perfusion dependent on the stage of right heart failure is a possible mechanism in EA, and that it can be correlated with cardiac magnetic resonance (CMR) parameters. The aim of this study was to investigate the relationship between BNP and haematological parameters with functional parameters from CMR and exercise testing in patients with EA. Methods and results Twenty-five patients with non-corrected EA were studied prospectively (mean age 26±14 years). BNP level was increased (74±127 ng/L), and in 16{\%} markedly above the heart failure cut-off level of 100 ng/L. Hb and Hct were increased above normal levels in 20 and 24{\%} of patients, respectively. BNP and Hct/Hb correlated with CMR [total right/left (R/L)-Volume-Index, right atrium-end-diastolic volume index (EDVi), functional right ventricle (fRV)-EDVi, fRV-ejection fraction (EF), tricuspid regurgitation, pulmonary artery flow, and left ventricular EF] and exercise testing [workload/kg, oxygen uptake (VO2), ventilatory response to carbon dioxide production (VE/VCO2), oxygen (O2) pulse, and heart rate reserve]. The higher BNP and haematological parameters, the higher was the disease severity and the more limited was the physical exercise capacity. Conclusion In this EA cohort, BNP levels and haematological parameters correlatedwell with functional data fromCMRand exercise testing. The total R/L-Volume-Index andBNP, and to some extent hematological parameters, may be useful as prognostic markers in patients with EA.",
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T1 - BNP and haematological parameters aremarkers of severity of Ebstein's anomaly

T2 - Correlation with CMR and cardiopulmonary exercise testing

AU - Hösch, Olga

AU - Ngyuen, Thuy Trang

AU - Lauerer, Peter

AU - Schuster, Andreas

AU - Kutty, Shelby

AU - Staab, Wieland

AU - Unterberg-Buchwald, Christina

AU - Sohns, Jan M.

AU - Paul, Thomas

AU - Lotz, Joachim

AU - Steinmetz, Michael

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Aims Ebstein's anomaly (EA) involves a displaced and dysplastic tricuspid valve resulting in an atrialized portion of the right ventricle and an enlargement of the functional right ventricle and right atrium. Biomarkers targeting heart failure such as brain natriuretic peptide (BNP) or haematological parameters [haemoglobin (Hb) and haematocrit (Hct)] are upregulated in states of pulmonary hypoperfusion.We hypothesized that decreased pulmonary perfusion dependent on the stage of right heart failure is a possible mechanism in EA, and that it can be correlated with cardiac magnetic resonance (CMR) parameters. The aim of this study was to investigate the relationship between BNP and haematological parameters with functional parameters from CMR and exercise testing in patients with EA. Methods and results Twenty-five patients with non-corrected EA were studied prospectively (mean age 26±14 years). BNP level was increased (74±127 ng/L), and in 16% markedly above the heart failure cut-off level of 100 ng/L. Hb and Hct were increased above normal levels in 20 and 24% of patients, respectively. BNP and Hct/Hb correlated with CMR [total right/left (R/L)-Volume-Index, right atrium-end-diastolic volume index (EDVi), functional right ventricle (fRV)-EDVi, fRV-ejection fraction (EF), tricuspid regurgitation, pulmonary artery flow, and left ventricular EF] and exercise testing [workload/kg, oxygen uptake (VO2), ventilatory response to carbon dioxide production (VE/VCO2), oxygen (O2) pulse, and heart rate reserve]. The higher BNP and haematological parameters, the higher was the disease severity and the more limited was the physical exercise capacity. Conclusion In this EA cohort, BNP levels and haematological parameters correlatedwell with functional data fromCMRand exercise testing. The total R/L-Volume-Index andBNP, and to some extent hematological parameters, may be useful as prognostic markers in patients with EA.

AB - Aims Ebstein's anomaly (EA) involves a displaced and dysplastic tricuspid valve resulting in an atrialized portion of the right ventricle and an enlargement of the functional right ventricle and right atrium. Biomarkers targeting heart failure such as brain natriuretic peptide (BNP) or haematological parameters [haemoglobin (Hb) and haematocrit (Hct)] are upregulated in states of pulmonary hypoperfusion.We hypothesized that decreased pulmonary perfusion dependent on the stage of right heart failure is a possible mechanism in EA, and that it can be correlated with cardiac magnetic resonance (CMR) parameters. The aim of this study was to investigate the relationship between BNP and haematological parameters with functional parameters from CMR and exercise testing in patients with EA. Methods and results Twenty-five patients with non-corrected EA were studied prospectively (mean age 26±14 years). BNP level was increased (74±127 ng/L), and in 16% markedly above the heart failure cut-off level of 100 ng/L. Hb and Hct were increased above normal levels in 20 and 24% of patients, respectively. BNP and Hct/Hb correlated with CMR [total right/left (R/L)-Volume-Index, right atrium-end-diastolic volume index (EDVi), functional right ventricle (fRV)-EDVi, fRV-ejection fraction (EF), tricuspid regurgitation, pulmonary artery flow, and left ventricular EF] and exercise testing [workload/kg, oxygen uptake (VO2), ventilatory response to carbon dioxide production (VE/VCO2), oxygen (O2) pulse, and heart rate reserve]. The higher BNP and haematological parameters, the higher was the disease severity and the more limited was the physical exercise capacity. Conclusion In this EA cohort, BNP levels and haematological parameters correlatedwell with functional data fromCMRand exercise testing. The total R/L-Volume-Index andBNP, and to some extent hematological parameters, may be useful as prognostic markers in patients with EA.

KW - Brain natriuretic peptide

KW - Cardiopulmonary exercise testing

KW - Cardiovascular magnetic resonance imaging

KW - Ebstein's anomaly

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