ArticleInternational journal of cardiology. Congenital heart disease2026
Prognostic value of serial NT-proBNP assay in adults with congenital heart disease and biventricular physiology.
Article in International journal of cardiology. Congenital heart disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The available data about the prognostic role of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in adults with congenital heart disease (CHD) are derived from small sample size with limited follow-up. The purpose of this study was to assess the role of NT-proBNP assay for prognostication in adults with CHD based on a large cohort. Method: Retrospective cohort study of adults with CHD, biventricular physiology, and systemic morphologic left ventricle who had ≥2 NT-proBNP measurements (2003-2023). Temporal change in NT-proBNP was calculated as relative change from baseline levels (relative Δ_NT-proBNP). Results: Of 3674 patients (age 42 ± 16 years; 47% males), median baseline and follow-up NT-proBNP levels were 178 (72; 539) pg/ml and 236 (103; 854) pg/ml, respectively. The relative Δ_NT-proBNP was 22% (-9, 51), and 2496 (68%) had temporal increase in NT-proBNP levels (i.e., relative Δ_NT-proBNP >0). The correlates of higher baseline NT-proBNP measurement were older age, atrial fibrillation, hepatorenal dysfunction, biventricular systolic dysfunction, and elevated biventricular filling pressures. Overall, 431 (12%) patients died during median follow-up. Both baseline NT-proBNP level and temporal increase in NT-proBNP were associated with all-cause mortality in all patient subgroups. Serial NT-proBNP measurement had superior prognostic value compared to single (baseline) NT-proBNP measurements and had superior prognostic performance compared to conventional clinical indices (echocardiographic indices, invasive hemodynamic indices, exercise test indices). Conclusions: NT-proBNP assay is inexpensive, readily available, and noninvasive, making it ideal for longitudinal monitoring. Further studies are required to determine whether NT-proBNP data can be used to guide therapeutic interventions in this population.
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