Reduced contractile reserve of the systemic right ventricle under Dobutamine stress is associated with increased brain natriuretic peptide levels in patients with complete transposition after atrial repair

Abstract

Aims

To compare B-type natriuretic peptide (BNP) levels with response of systemic right ventricular function to Dobutamine stress.

Methods and results

Sixteen patients aged 25.6 ± 3.7 years (eight each after Senning or Mustard repair of complete transposition) were studied. Transoesophageal imaging was performed in the catheterization laboratory under general anaesthesia before and at the end of a 10 min infusion of 5 µg/kg/min of Dobutamine. The BNP levels were measured at rest. Myocardial Doppler data were acquired before and at peak stress in a four-chamber view. The BNP (pg/mL) values of 67.3 ± 47.5 (14–189) were elevated. There was no correlation between BNP and IVA, strain, or systolic and diastolic velocities at rest. Dobutamine stress led to a significant increase in IVA, s-velocity, and strain but no significant change in e-velocity. A correlation was found between increase in IVA under Dobutamine and BNP levels ( r = 0.57, P < 0.02).

Conclusion

Elevated BNP levels correlate with response of systolic right ventricular function assessed by IVA to Dobutamine stress.

Systemic right ventricle, Congenital heart disease, Myocardial Doppler