N-terminal pro-B-type natriuretic peptide predicts cardiovascular complications in pregnant women with congenital heart disease.

Autor:	Kampman MA; Department of Cardiology, Thorax Centre, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700RB, The Netherlands., Balci A, van Veldhuisen DJ, van Dijk AP, Roos-Hesselink JW, Sollie-Szarynska KM, Ludwig-Ruitenberg M, van Melle JP, Mulder BJ, Pieper PG
Jazyk:	angličtina
Zdroj:	European heart journal [Eur Heart J] 2014 Mar; Vol. 35 (11), pp. 708-15. Date of Electronic Publication: 2013 Dec 13.
DOI:	10.1093/eurheartj/eht526
Abstrakt:	Aims: In women with congenital heart disease (CHD), cardiovascular complications during pregnancy are common, but the risk assessment of these patients remains difficult. This study sought to determine the independent role of N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in addition to other parameters in predicting adverse cardiovascular events during pregnancy in women with CHD. Methods and Results: We conducted a national, prospective multicentre cohort study. Follow-up with clinical evaluation and echocardiography and NT-proBNP measurement was performed at 20-week gestation. Adverse cardiovascular events occurred in 10.3% of 213 pregnancies. N-terminal pro-B-type natriuretic peptide levels >128 pg/mL at 20-week gestation, the presence of a mechanical valve, and subpulmonary ventricular dysfunction before conception were independently associated with events [odds ratio (OR) 10.6 (P = 0.039), OR 12.0 (P = 0.016), and OR 4.2 (P = 0.041), respectively]. The negative predictive value of NT-proBNP levels <128 pg/mL was 96.9%. N-terminal pro-B-type natriuretic peptide levels >128 pg/mL at 20 weeks of gestation had an additional value in predicting the occurrence of adverse cardiovascular events on the top of the other identified predictors (area under the curve 0.90 vs. 0.78, P = 0.035). Conclusion: Increased NT-proBNP levels at 20 weeks of gestation are an independent risk predictor of cardiovascular events during pregnancy in women with CHD.
Databáze:	MEDLINE
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