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Adults with congenital heart disease (ACHD) are an increasing and ageing population.1 Despite all advances in medical and surgical treatment, patients with ACHD are still afflicted by significant morbidity and mortality.2 Timely identification of those patients that are at risk can be difficult. In acquired cardiovascular disease, biomarkers play an important role for the diagnosis and even for monitoring the treatment. Brain natriuretic peptides, which are firmly established in the diagnosis and management of heart failure due to acquired cardiovascular disease, have value in patients with ACHD, but are burdened with some limitations, for example, no real cut-off values due to the pathophysiological variety of the underlying congenital heart defects. Furthermore, brain natriuretic peptide values can differ widely, hence conclusions for individual patients can only be drawn with caution.3 Therefore, the search for other …
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