Neurohormonal activation and symptoms in tetralogy of Fallot patients
| Total (n=90) | Asymptomatic (n=64) | Symptomatic (n=26) | p Value | |
|---|---|---|---|---|
| Age at study, years | 32.7±11.3 | 31.0±10.6 | 36.8±11.9 | 0.03 |
| Neurohormones | ||||
| ANP (pmol/L) | 6.9 (4.0–9.9) | 5.3 (3.3–8.5) | 8.5 (6.1–21.0) | <0.05 |
| BNP (pmol/L) | 8.9 (5.9–14.6) | 8.9 (5.8–12.7) | 11.4 (6.2–33.7) | 0.04 |
| Endothelin-1 (pmol/L) | 1.14 (0.94–1.48) | 1.10 (0.92–1.37) | 1.24 (1.00–2.10) | 0.16 |
| Renin (pmol/L) | 55.0 (45.5–66.5) | 54.5 (45.0–64.8) | 56.0 (50.0–78.5) | 0.02 |
| Aldosterone (nmol/L) | 357 (295–450) | 346 (295–400) | 485 (355–787) | <0.05 |
| Biochemical parameters | ||||
| Haemoglobin (g/dL) | 14.8±1.64 | 14.9±1.33 | 14.6±2.25 | 0.38 |
| Sodium (mmol/L) | 138.3±2.16 | 138.6±1.98 | 137.4±2.33 | 0.01 |
| Creatinine (micmol/L) | 78.8±19.4 | 77.5±14.6 | 82.0±28.1 | 0.32 |
| Urate (micmol/L) | 325.6±79.0 | 330.9±77.0 | 313.0±83.6 | 0.34 |
| CRP (mg/L) | 7.51±3.57 | 7.39±2.39 | 7.74±5.19 | 0.78 |
| Cardiopulmonary exercise testing (RER >1) | (n=52) | (n=13) | ||
| Peak VO2 (mL/kg/min) | 27.0±8.4 | 28.1±8.7 | 22.3±5.1 | <0.05 |
| Predicted peak VO2 (%) | 79.4±18.1 | 82.7±17.6 | 65.7±13.5 | <0.05 |
| VE/VCO2 | 29.5±7.4 | 29.0±7.4 | 31.2±7.1 | 0.34 |
| Anaerobic threshold (mL/kg/min) | 16.9±5.2 | 17.5±7.3 | 14.6±4.5 | 0.12 |
| QRS duration (ms) | 147±28.3 | 145±26.3 | 131±21.5 | 0.04 |
| Cardiothoracic ratio | 0.55±0.06 | 0.54±0.05 | 0.60±0.07 | <0.05 |
| CMR parameters | ||||
| RVEDV indexed (mL/m2) | 130.1±44.7 | 125.1±34.9 | 143.6±63.1 | 0.40 |
| RVESV indexed (mL/m2) | 64.3±36.7 | 58.3±24.5 | 80.5±55.7 | 0.13 |
| RVSV indexed (mL/m2) | 65.6±18.6 | 66.5±18.9 | 63.2±17.9 | 0.48 |
| RVEF (%) | 52.3±11.3 | 53.9±10.5 | 48.1±17.9 | 0.03 |
| RV indexed mass (g/m2) | 57.3±17.4 | 56.5±14.0 | 59.6±24.7 | 0.58 |
| LVEDV indexed (mL/m2) | 72.5±18.8 | 69.4±15.4 | 80.7±24.4 | 0.02 |
| LVESV indexed (mL/m2) | 27.1±10.4 | 24.7±8.2 | 33.3±13.2 | <0.05 |
| LVSV indexed (mL/m2) | 45.5±11.7 | 44.7±10.4 | 47.9±14.7 | 0.34 |
| LVEF (%) | 63.4±7.9 | 64.6±7.7 | 60.3±8.0 | 0.03 |
| LV indexed mass (g/m2) | 63.7±18.7 | 63.0±13.7 | 65.5±28.4 | 0.69 |
| ≥Moderate pulmonary stenosis*, n | 8 | 4 | 4 | 0.17 |
| ≥Moderate pulmonary regurgitation, n | 78 | 56 | 22 | 0.72 |
| ≥Moderate pulmonary regurgitation or stenosis, n | 80 | 58 | 22 | 0.41 |
| Pulmonary regurgitant fraction (%) | 29.9±14.8 | 33.0±14.2 | 21.6±13.3 | <0.05 |
*Moderate pulmonary stenosis=peak velocity ≥3 m/s.
ANP, atrial natriuretic peptide; BNP, brain natriuretic peptide; CMR, cardiovascular magnetic resonance; LVEDV, LV end-diastolic volume; LVESV, LV end-systolic volume; LVSV, LV stroke volume; RVEDV, RV end-diastolic volume; RVESV, RV end-systolic volume; RVSV, RV stroke volume; CRP, C-reactive protein; VE/VCO2, ventilatory efficiency; VO2, peak oxygen uptake; RER, respiratory exchange ratio.