Evidence map›Paper›PMID 24079880›Full record

ArticleThe Journal of thoracic and cardiovascular surgery2014

Preoperative B-type natriuretic peptide levels are associated with outcome after total cavopulmonary connection (Fontan).

Monique Radman, Roberta L Keller, Peter Oishi, Sanjeev A Datar, Kari Wellnitz, Anthony Azakie, Frank Hanley, Danton Char, Jong-Hau Hsu, Rambod Amrinovin and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of thoracic and cardiovascular surgery, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 5 institutions in 3 countries.

Monique RadmanDepartment of Pediatrics, University of California, San Francisco, Calif; Cardiovascular Research Institute, University of California, San Francisco, Calif.
Roberta L KellerDepartment of Pediatrics, University of California, San Francisco, Calif.
Peter OishiDepartment of Pediatrics, University of California, San Francisco, Calif; Cardiovascular Research Institute, University of California, San Francisco, Calif.
Sanjeev A DatarDepartment of Pediatrics, University of California, San Francisco, Calif.
Kari WellnitzDepartment of Pediatrics, University of California, San Francisco, Calif.
Anthony AzakieDepartment of Surgery, University of California, San Francisco, Calif.
Frank HanleyDepartment of Surgery, Stanford University, Palo Alto, Calif.
Danton CharDepartment of Anesthesia, Stanford University, Palo Alto, Calif.
Jong-Hau HsuDepartment of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Rambod AmrinovinDepartment of Anesthesia, Children's Hospital Los Angeles, Los Angeles, Calif.
Ian AdatiaDepartment of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
Jeffrey R FinemanDepartment of Pediatrics, University of California, San Francisco, Calif; Cardiovascular Research Institute, University of California, San Francisco, Calif. Electronic address: Jeff.fineman@ucsf.edu.
University of California, San Francisco · USStanford University · USChildren's Hospital of Los Angeles · USKaohsiung Medical University · TWUniversity of Alberta · CA

Funding

UCSF CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTEUL1RR024131 · NCRR · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI JOHNSTON, S. CLAIBORNE · 2006 to 2011
$111.2M
ZIDOVUDINE &LAMIVUDINE &NEVIRAPINE COMBINATION THERAPY IN HIV 1 INFM01RR001271 · NCRR · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI KESSLER, DAVID A · 1985 to 2006
$22.7M
Pediatric Critical Care Scientist Development ProgramK12HD047349 · NICHD · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · PI HEATHER T. KEENAN, Kevin M Watt · 2004 to 2026
$17.0M
PERINATAL PULMONARY HYPERTENSION: DEVELOPMENT MEDIATORSR01HL061284 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI FINEMAN, JEFFREY R · 1999 to 2016
$8.3M
Research Training in Pediatric Critical Care MedicineT32HD049303 · NICHD · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI JEFFREY R FINEMAN · 2006 to 2026
$3.1M
UCSF Clinical Research Center for Prematurity and Respiratory Outcomes ProgramU01HL101798 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI BALLARD, PHILIP L., KELLER, ROBERTA L · 2010 to 2014
$2.1M
Vascular Dysfunction with Increased Pulmonary Blood Flow: A role for PPAR GammaK08HL086513 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI OISHI, PETER ERIC · 2007 to 2010
$487k
NCRR NIH HHS M01 RR001271NCRR NIH HHS UL1 RR024131NCRR NIH HHS UL RR024131-01NHLBI NIH HHS HL61284NHLBI NIH HHS K08 HL086513NHLBI NIH HHS K08HL086513NHLBI NIH HHS R01 HL061284NHLBI NIH HHS U01 HL101798NICHD NIH HHS T32 HD049303
6 · The paper itself

Abstract

objectiveThe study objective was to determine the association between preoperative B-type natriuretic peptide levels and outcome after total cavopulmonary connection. Surgical palliation of univentricular cardiac defects requires a series of staged operations, ending in a total cavopulmonary connection. Although outcomes have improved, there remains an unpredictable risk of early total cavopulmonary connection takedown. The prediction of adverse postoperative outcomes is imprecise, despite an extensive preoperative evaluation.

methodsWe prospectively enrolled 50 patients undergoing total cavopulmonary connection. We collected preoperative clinical data, preoperative plasma B-type natriuretic peptide levels, and postoperative outcomes, including the incidence of an adverse outcome within 1 year of surgery (defined as death, total cavopulmonary connection takedown, or the need for cardiac transplantation).

resultsThe mean age of patients was 4.7 years (standard deviation, 2.1 years). The median (interquartile range) preoperative B-type natriuretic peptide levels were higher in patients who required total cavopulmonary connection takedown and early postoperative mechanical cardiac support (n = 3; median, 55; interquartile range, 42-121) compared with those with a good outcome (n = 47; median, 11; interquartile range, 5-17) (P < .05). A preoperative B-type natriuretic peptide level of 40 pg/mL or greater was highly associated with the need for total cavopulmonary connection takedown (sensitivity, 100%; specificity, 93%; P < .05), yielding a positive predictive value of 50% and a negative predictive value of 100%. Higher preoperative B-type natriuretic peptide levels also were associated with longer intensive care unit length of stay, longer hospital length of stay, and increased incidence of low cardiac output syndrome (P < .05).

conclusionsPreoperative B-type natriuretic peptide blood levels are uniquely associated with the need for mechanical support early after total cavopulmonary connection and total cavopulmonary connection takedown, and thus may provide important information in addition to the standard preoperative assessment.

Indexed as

Fontan ProcedureBiomarkersChildChild, PreschoolFemaleHeart Defects, CongenitalHumansMaleNatriuretic Peptide, BrainPalliative CarePostoperative ComplicationsProspective StudiesReoperationRisk FactorsTime FactorsTreatment OutcomeBiomarkersNatriuretic Peptide, Brain

Identifiers

PMID24079880
PMCPMC3968237
OpenAlexW2088640210

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.