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Utility of biomarkers in adult Fontan patients with decompensated heart failure

  • Vidang P. Nguyen (a1), Song Li (a2), Stephen J. Dolgner (a2) (a3), Zachary L. Steinberg (a2) and Jonathan Buber (a2)...



The incidence of heart failure is increasing within the Fontan population. The use of serological markers, including B-type natriuretic peptide, has been limited in this patient population.


This was a single-centre retrospective study of Fontan patients in acute decompensated heart failure. Fontan patients underwent a 1:2 match with non-Fontan patients for each heart failure hospitalisation for comparative analysis. A univariate logistic regression model was used to assess associations between laboratory and echocardiographic markers and a prolonged length of stay of 7 days or greater.


B-type natriuretic peptide levels were significantly lower in Fontan patients admitted for heart failure than that in non-Fontan patients [390.9 (±378.7) pg/ml versus 1245.6 (±1160.7) pg/ml, respectively, p < 0.0001] and were higher in Fontan patients with systemic ventricular systolic or diastolic dysfunction than that in Fontan patients with normal systemic ventricular function [833.6 (±1547.2) pg/ml versus 138.6 (±134.0) pg/ml, p = 0.017]. The change from the last known outpatient value was smaller in Fontan patients in comparison with non-Fontan patients [65.7 (±185.7) pg/ml versus 1638.0 (±1444.7) pg/ml, respectively, p < 0.0001]. Low haemoglobin and high blood urea nitrogen levels were associated with a prolonged length of stay.


B-type natriuretic peptide levels do not accurately reflect decompensated heart failure in Fontan patients when compared to non-Fontan heart failure patients and should, therefore, be used with caution in this patient population.


Corresponding author

Author for correspondence: Vidang Nguyen, Department of Cardiology, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Third Floor Cardiology, Room A3308, Los Angeles, CA, USA. Tel: +1 206 330 1762; Fax: +1 424 315 2880. E-mail:


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Utility of biomarkers in adult Fontan patients with decompensated heart failure

  • Vidang P. Nguyen (a1), Song Li (a2), Stephen J. Dolgner (a2) (a3), Zachary L. Steinberg (a2) and Jonathan Buber (a2)...


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