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Association between N-terminal pro-brain natriuretic peptide and quality of life in adult patients with congenital heart disease

Published online by Cambridge University Press:  21 November 2013

John O. Younge ,
Jannet A. Eindhoven ,
Elisabeth W. M. J. Utens ,
Petra Opić ,
Judith A. A. E. Cuypers ,
Annemien E. van den Bosch ,
Maarten Witsenburg ,
Ron T. van Domburg ,
M. G. Myriam Hunink  and
Jolien W. Roos-Hesselink
John O. Younge
Affiliation:
Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands Department of Clinical Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
Jannet A. Eindhoven
Affiliation:
Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
Elisabeth W. M. J. Utens
Affiliation:
Department of Adolescent Psychiatry/Psychology, Erasmus Medical Center, Rotterdam, The Netherlands
Petra Opić
Affiliation:
Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
Judith A. A. E. Cuypers
Affiliation:
Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
Annemien E. van den Bosch
Affiliation:
Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
Maarten Witsenburg
Affiliation:
Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
Ron T. van Domburg
Affiliation:
Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
M. G. Myriam Hunink
Affiliation:
Department of Clinical Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
Jolien W. Roos-Hesselink*
Affiliation:
Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
*
Correspondence to: J. W. Roos-Hesselink, Department of Cardiology, Ba-583, ‘s-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands. Tel: +31(0)10 7032432; Fax:+31(0)10 7035498; E-mail: j.roos@erasmusmc.nl
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Abstract

Aims: Advances in medical treatment have resulted in increased life expectancy in congenital heart disease. Consequently, the focus of management has shifted from reducing mortality to reducing long-term morbidity with the goal of improving quality of life. A predictor of quality of life might be N-terminal pro-brain natriuretic peptide, a well-established marker for heart failure. We aimed to determine the association between N-terminal pro-brain natriuretic peptide and quality of life in patients with congenital heart disease. Methods: We collected blood samples from consecutive patients who were initially operated between 1968 and 1980 (47.8% women; mean age 40.2±5.4 years). The 36-item Short-Form Health Survey was completed to assess subjective health status as a measure of quality of life. Analysis was performed for the entire group and for subgroups defined as simple versus complex congenital heart diseases. Median N-terminal pro-brain natriuretic peptide level was 15.2 pmol/L (overall range 1.3–299.3 pmol/L). N-terminal pro-brain natriuretic peptide levels were associated with the subdomain physical functioning (β=−0.074, p=0.031). This association remained significant after adjustment for age and sex (β=−0.071, p=0.038) and after adjustment for age, sex, body mass index, left ventricular function, and renal function (β=−0.069, p=0.048). In complex congenital heart disease, the association between N-terminal pro-brain natriuretic peptide and physical functioning remained significant in multivariable analysis (β=−0.076, p=0.046). No associations were found in the simple congenital heart disease group or on the other health status subdomains. Conclusion: In adults operated for congenital heart disease, N-terminal pro-brain natriuretic peptide is associated with the subdomain physical, primarily in the complex subgroup.

Keywords

Congenital heart diseasequality of lifenatriuretic peptides
Type
Original Articles
Information
Cardiology in the Young , Volume 25 , Issue 2 , February 2015 , pp. 288 - 294
Copyright
Copyright © Cambridge University Press 2013 

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References

1. Brickner, ME, Hillis, LD, Lange, RA. Congenital heart disease in adults. First of two parts. N Engl J Med 2000; 342: 256–263.Google Scholar
2. Immer, FF, Althaus, SM, Berdat, PA, Saner, H, Carrel, TP. Quality of life and specific problems after cardiac surgery in adolescents and adults with congenital heart diseases. Eur J Cardiovasc Prev Rehabil 2005; 12: 138–143.Google Scholar
3. Saliba, Z, Butera, G, Bonnet, D, et al. Quality of life and perceived health status in surviving adults with univentricular heart. Heart 2001; 86: 69–73.Google Scholar
4. Moons, P, Van Deyk, K, De Bleser, L, et al. Quality of life and health status in adults with congenital heart disease: a direct comparison with healthy counterparts. Eur J Cardiovasc Prev Rehabil 2006; 13: 407–413.Google Scholar
5. Jefferies, JL, Noonan, JA, Keller, BB, Wilson, JF, Griffith, C III. Quality of life and social outcomes in adults with congenital heart disease living in rural areas of Kentucky. Am J Cardiol 2004; 94: 263–266.Google Scholar
6. Kamphuis, M, Ottenkamp, J, Vliegen, HW, et al. Health related quality of life and health status in adult survivors with previously operated complex congenital heart disease. Heart 2002; 87: 356–362.Google Scholar
7. Simko, LC, McGinnis, KA. What is the perceived quality of life of adults with congenital heart disease and does it differ by anomaly? J Cardiovasc Nurs 2005; 20: 206–214.Google Scholar
8. Bettencourt, P, Azevedo, A, Pimenta, J, Frioes, F, Ferreira, S, Ferreira, A. N-terminal-pro-brain natriuretic peptide predicts outcome after hospital discharge in heart failure patients. Circulation 2004; 110: 2168–2174.Google Scholar
9. Gardner, RS, Ozalp, F, Murday, AJ, Robb, SD, McDonagh, TA. N-terminal pro-brain natriuretic peptide. A new gold standard in predicting mortality in patients with advanced heart failure. Eur Heart J 2003; 24: 1735–1743.CrossRefGoogle ScholarPubMed
10. Januzzi, JL Jr, Camargo, CA, Anwaruddin, S, et al. The N-terminal Pro-BNP investigation of dyspnea in the emergency department (PRIDE) study. Am J Cardiol 2005; 95: 948–954.Google Scholar
11. Maeda, K, Tsutamoto, T, Wada, A, et al. High levels of plasma brain natriuretic peptide and interleukin-6 after optimized treatment for heart failure are independent risk factors for morbidity and mortality in patients with congestive heart failure. J Am Coll Cardiol 2000; 36: 1587–1593.CrossRefGoogle ScholarPubMed
12. Eindhoven, JA, van den Bosch, AE, Boersma, E, Roos-Hesselink, JW. The usefulness of brain natriuretic peptide in simple congenital heart disease – a systematic review. Cardiol Young 2012: 1–10.Google ScholarPubMed
13. Eindhoven, JA, van den Bosch, AE, Jansen, PR, Boersma, E, Roos-Hesselink, JW. The usefulness of brain natriuretic peptide in complex congenital heart disease: a systematic review. J Am Coll Cardiol 2012; 60: 2140–2149.Google Scholar
14. Luther, SA, McCullough, PA, Havranek, EP, et al. The relationship between B-type natriuretic peptide and health status in patients with heart failure. J Card Fail 2005; 11: 414–421.Google Scholar
15. Utens, EM, Verhulst, FC, Erdman, RA, et al. Psychosocial functioning of young adults after surgical correction for congenital heart disease in childhood: a follow-up study. J Psychosom Res 1994; 38: 745–758.CrossRefGoogle ScholarPubMed
16. van Rijen, EH, Utens, EM, Roos-Hesselink, JW, et al. Psychosocial functioning of the adult with congenital heart disease: a 20-33 years follow-up. Eur Heart J 2003; 24: 673–683.Google Scholar
17. Ware, JE Jr, Sherbourne, CD. The MOS 36-item Short-Form Health Survey (SF-36). I. Conceptual framework and item selection. Med Care 1992; 30: 473–483.Google Scholar
18. Aaronson, NK, Muller, M, Cohen, PD, et al. Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. J Clin Epidemiol 1998; 51: 1055–1068.Google Scholar
19. Warnes, CA, Liberthson, R, Danielson, GK, et al. Task force 1: the changing profile of congenital heart disease in adult life. J Am Coll Cardiol 2001; 37: 1170–1175.Google Scholar
20. Popelova, J, Slavik, Z, Skovranek, J. Are cyanosed adults with congenital cardiac malformations depressed? Cardiol Young 2001; 11: 379–384.Google Scholar
21. Moons, P, Van Deyk, K, De Geest, S, Gewillig, M, Budts, W. Is the severity of congenital heart disease associated with the quality of life and perceived health of adult patients? Heart 2005; 91: 1193–1198.CrossRefGoogle ScholarPubMed
22. Moons, P, Van Deyk, K, Budts, W, De Geest, S. Caliber of quality-of-life assessments in congenital heart disease: a plea for more conceptual and methodological rigor. Arch Pediatr Adolesc Med 2004; 158: 1062–1069.CrossRefGoogle ScholarPubMed
23. De Bleser, L, Budts, W, Sluysmans, T, et al. Self-reported physical activities in patients after the Mustard or Senning operation: comparison with healthy control subjects. Eur J Cardiovasc Nurs 2007; 6: 247–251.Google Scholar
24. Kempny, A, Dimopoulos, K, Uebing, A, et al. Reference values for exercise limitations among adults with congenital heart disease. Relation to activities of daily life – single centre experience and review of published data. Eur Heart J 2012; 33: 1386–1396.Google Scholar
25. Trojnarska, O, Gwizdala, A, Katarzynski, S, et al. The BNP concentrations and exercise capacity assessment with cardiopulmonary stress test in cyanotic adult patients with congenital heart diseases. Int J Cardiol 2010; 139: 241–247.CrossRefGoogle ScholarPubMed
26. Cheung, EW, Lam, WW, Chiu, CS, Chau, AK, Cheung, SC, Cheung, YF. Plasma brain natriuretic peptide levels, right ventricular volume overload and exercise capacity in adolescents after surgical repair of tetralogy of Fallot. Int J Cardiol 2007; 121: 155–162.Google Scholar
27. Norozi, K, Buchhorn, R, Bartmus, D, et al. Elevated brain natriuretic peptide and reduced exercise capacity in adult patients operated on for tetralogy of Fallot is due to biventricular dysfunction as determined by the myocardial performance index. Am J Cardiol 2006; 97: 1377–1382.Google Scholar
28. Iversen, K, Jensen, AS, Jensen, TV, Vejlstrup, NG, Sondergaard, L. Combination therapy with bosentan and sildenafil in Eisenmenger syndrome: a randomized, placebo-controlled, double-blinded trial. Eur Heart J 2010; 31: 1124–1131.Google Scholar
29. Lechner, E, Schreier-Lechner, EM, Hofer, A, et al. Aminoterminal brain-type natriuretic peptide levels correlate with heart failure in patients with bidirectional Glenn anastomosis and with morbidity after the Fontan operation. J Thorac Cardiovasc Surg 2009; 138: 560–564.CrossRefGoogle ScholarPubMed
30. Motoki, N, Ohuchi, H, Miyazaki, A, Yamada, O. Clinical profiles of adult patients with single ventricular physiology. Circ J 2009; 73: 1711–1716.Google Scholar
31. Hogenhuis, J, Jaarsma, T, Voors, AA, Hillege, HL, Lesman, I, van Veldhuisen, DJ. Correlates of B-type natriuretic peptide and 6-min walk in heart failure patients. Int J Cardiol 2006; 108: 63–67.Google Scholar
32. Eindhoven, JA, van den Bosch, AE, Ruys, TP, et al. N-terminal proBrain natriuretic peptide and its relation with cardiac function in adult patients with congenital heart disease. J Am Coll Cardiol 2013; 62: 1203–1212.Google Scholar
33. Popelova, J, Kotaska, K, Cerny, S, Prokopova, M, Rubacek, M. Range and distribution of NT-proBNP values in stable corrected congenital heart disease of various types. Can J Cardiol 2012; 28: 471–476.Google Scholar