ArticleCongenital heart disease
Factors associated with serum brain natriuretic peptide levels after the Fontan procedure.
Article in Congenital heart disease. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 47 citations in OpenAlex.
- Factors associated with serum B-type natriuretic peptide in infants with single ventricles.Pediatric cardiology · 2014Trial
- Cardiac performance and quality of life in patients who have undergone the Fontan procedure with and without prior superior cavopulmonary connection.Cardiology in the young · 2013Trial
- NT-proBNP and other blood biomarkers in patients after Fontan Surgery: Prognostic, diagnostic, and management implications.International journal of cardiology. Congenital heart disease · 2026Article
- Impact of Systemic Ventricular Morphology on Age-Adjusted (zlog-)NT-proBNP in Children with Univentricular Hearts.Pediatric cardiology · 2026Article
- Article
- Circulating Biomarkers in Failing Fontan Circulation: Current Evidence and Future Directions.Journal of cardiovascular development and disease · 2025Review
- Blood Biomarkers as a Non-Invasive Method for the Assessment of the State of the Fontan Circulation.Journal of clinical medicine · 2025Review
- Diuretic use in the adult Fontan.International journal of cardiology. Congenital heart disease · 2022Article
- Fitter Fontans for future-Impact of physical exercise on cardiopulmonary function in Fontan patients.Frontiers in cardiovascular medicine · 2022Article
- Fontan-Associated Dyslipidemia.Journal of the American Heart Association · 2021Article
- Longitudinal Outcomes of Patients With Single Ventricle After the Fontan Procedure.Journal of the American College of Cardiology · 2017Article
- Alkaline Phosphatase: A Biomarker of Cardiac Function in Pediatric Patients.Pediatric cardiology · 2017Article
- Assessment of Quality of Life in Young Patients with Single Ventricle after the Fontan Operation.The Journal of pediatrics · 2016Observational
- Biomarkers and the Fontan Circulation.Journal of the American Heart Association · 2016Article
- Usefulness of insulin like growth factor 1 as a marker of heart failure in children and young adults after the Fontan palliation procedure.The American journal of cardiology · 2015Article
- The potential and limitations of plasma BNP measurement in the diagnosis, prognosis, and management of children with heart failure due to congenital cardiac disease: an update.Heart failure reviews · 2014Review
- Heart failure in adult congenital heart disease.Current treatment options in cardiovascular medicine · 2014Article
- Preoperative B-type natriuretic peptide levels are associated with outcome after total cavopulmonary connection (Fontan).The Journal of thoracic and cardiovascular surgery · 2014Article
- Article
- Increase in N-terminus-pro-B-type natriuretic peptide during exercise of patients with univentricular heart after a total cavopulmonary connection.Pediatric cardiology · 2012Article
Corrections and comments
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Authors and funding
13 authors at 9 institutions in 2 countries.
Funding
Abstract
objectiveAlthough a useful marker of heart failure in adults, the utility of brain natriuretic peptide concentration (BNP) for children after the Fontan procedure is not well studied.
designBNP was measured in 510 patients who were 6-18 years old in the Pediatric Heart Network Fontan cross-sectional study at a median of 8.2 years after Fontan. Patients underwent echocardiography, exercise testing, magnetic resonance imaging (MRI) and functional health status questionnaires. Associations of BNP with baseline patient characteristics, medical history and cross-sectional assessment were examined with multivariable linear regression analyses.
resultsThe distribution of BNP was highly skewed, median 13.0 pg/mL (interquartile range: 7.1, 25.9), and was normalized with logarithmic transformation (logBNP). Among medical history variables, logBNP was greater in females (P= .02) and older patients (P < .001). Presence of pre-Fontan systolic ventricular dysfunction, greater number of post-Fontan complications, and thrombosis after Fontan were independently associated with higher logBNP (R(2) = 0.16). Age-adjusted logBNP was significantly related to Fontan connection type (lower with extracardiac conduits, higher with atriopulmonary connection; P < .001). Lower physical functioning health status (R(2) = 0.05), lower chronotropic index during exercise (R(2) = 0.17), indices of diastolic dysfunction measured by echocardiography (R(2) = 0.15), and higher total ventricular mass on MRI (R(2) = 0.33) were related to higher logBNP.
conclusionsDespite a markedly abnormal circulation, BNP was variable but within a normal range in the majority of Fontan patients in this large outpatient cohort. Higher BNP was associated with several markers of suboptimal outcome, although associations were weak. The routine use of BNP as an outpatient surveillance tool in asymptomatic Fontan patients is not warranted.
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