Left ventricular adaptation after ASD closure assessed by elevated levels of NT-proBNP and cardiac MRI in adult patients

Michael Weber ^1*, Thorsten Dill ¹, Anja Deetjen ¹, Thomas Neumann ², Okan Ekinci ¹, Jochen Hansel ¹, Albrecht Elsaesser ¹, Veselin Mitrovic ¹ and Christian Hamm ¹

¹ Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany
² Department of Cardiology, Justus Liebeig University, Giessen, Germany

^* To whom correspondence should be addressed. E-mail: m.weber{at}kerckhoff-klinik.de.

Accepted 11 August 2005

Abstract

Aim:The aim of this observational study was to determine whether NT-proBNP is elevated in patients with an ASD and whether values change after interventional closure.

Methods and results: Twelve patients (6 male, aged 44.4 ± 18.6 years) with a moderate sized ASD type II (23.3 ± 4.5 mm, Qp/Qs 2.1 ± 0.68) were investigated. In all patients a MRI study was performed and NT-proBNP was assessed at baseline, early (9 ± 13 days) and late (138 ± 64 days) after interventional therapy. Values for NT-proBNP were found within the normal range at baseline (87 pg/ml; 65-181 pg/ml), but increased early after the interventional closure (315 pg/ml; 133-384 pg/ml, p=0.005 vs. baseline). The increase of NT-proBNP was associated to an increase in left ventricular dimensions as assessed by MRI (LVEDV 104 ± 27 ml to 118 ± 27 ml, p=0.003). Late after ASD closure NT-proBNP values returned to baseline values (97 pg/ml; 82-188 pg/ml, p=0.004 vs. early follow up).

Conclusion: These findings suggest transitory haemodynamic stress during adaptation of the left ventricle after ASD closure and therefore might contribute to the understanding of the pathomechanism of acute heart failure and delayed improvement of exercise capacity following ASD closure.

Keywords: atrial septal defect, cardiac MRI, interventional ASD closure, NT-proBNP, natriuretic peptides

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Schoen, S.P., Zimmermann, T., Kittner, T., Braun, M.U., Fuhrmann, J., Schmeisser, A., Strasser, R.H. (2007). NT-proBNP correlates with right heart haemodynamic parameters and volumes in patients with atrial septal defects. Eur J Heart Fail 9: 660-666 [Abstract] [Full Text]