2016


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2016/№1

Biochemical markers of heart failure in children with a functional single ventricle after the Fontan surgery with extracardiac conduit

Tupikina A. A.1, Plotnikova I. V.1, Kovalev I. A.2, Svintsova L. I.1, Yanulevich O. S.1, Krivoshchekov E. V.1
1 – Federal State Budgetary Institution, “Research Institute of Cardiology” of the Russian Academy of Medical Sciences Siberian Branch, Kievskaya 111a, Tomsk 634012
2 – Stand-alone Unit of the State Budgetary Educational Institution of Higher Professional Education, N.I. Pirogov Russian National Research Institute at the Ministry of Health Care, Academician Yu.E. Veltishchev Research Clinical Institute of Pediatrics”, Taldomskaya 2, Moscow 125412

Keywords: functional single heart ventricle, heart failure, endothelial dysfunction, myocardial injury, total cavopulmonary connection

DOI: 10.18087/rhfj.2016.1.2188

Background. It was presently demonstrated that approximately one-third of patients with congenital heart defects (CHD), including CHD with functional single heart ventricle (FSHV), had signs of HF. Aim. To evaluate biochemical markers of HF, myocardial injury, and endothelial dysfunction in children with FSHV one year after total cavopulmonary connection (TCPC). Materials and methods. 29 patients aged 3 to 16 years with FSHV following TCPC with extracardiac conduit were studied one year after the surgery. Mean age of patients was 7.7 years±3.6 months. A comprehensive examination was performed for all patients, including ECG, ECG HM, EchoCG, measurement of biochemical markers for HF and endothelial dysfunction (FABP, ANP, BNP, NT-proBNР, and endothelin 1). Results. Increased levels of BNP were found in 27 (93.1 %) children one year following the Fontan surgery. Median BNP was increased in groups 1 and 2, 204 pg/ml (IQR:129-355) and 211 pg/ml (IQR:92-327), respectively. Median NT-proBNP was increased in group 2, 123.9 pg/ml (IQR: 52.9-370.5). Median endothelin 1 level exceeded reference values in both groups, 44.4 (IQR: 14-100.3) and 42.3 (IQR: 6.2-155.8). Conclusion. One year following TCPC, most patients with FSHV (82.8 %) had higher than threshold blood levels of BNP and NT-proBNP. Mean pre-TCPC pulmonary artery pressure directly correlated with time-related changes in the level of NT-proBNP after the surgery (r=0.54; р=0.04).
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Tupikina A. A., Plotnikova I. V., Kovalev I. A., Svintsova L. I., Yanulevich O. S., Krivoshchekov E. V. Biochemical markers of heart failure in children with a functional single ventricle after the Fontan surgery with extracardiac conduit. Russian Heart Failure Journal. 2016;17 (1):21–26

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