Reduced contractile reserve of the systemic right ventricle under Dobutamine stress is associated with increased brain natriuretic peptide levels in patients with complete transposition after atrial repair

Eur J Echocardiogr. 2009 Jul;10(5):691-4. doi: 10.1093/ejechocard/jep047. Epub 2009 Apr 28.

Abstract

Aims: To compare B-type natriuretic peptide (BNP) levels with response of systemic right ventricular function to Dobutamine stress.

Methods and results: Sixteen patients aged 25.6 +/- 3.7 years (eight each after Senning or Mustard repair of complete transposition) were studied. Transoesophageal imaging was performed in the catheterization laboratory under general anaesthesia before and at the end of a 10 min infusion of 5 microg/kg/min of Dobutamine. The BNP levels were measured at rest. Myocardial Doppler data were acquired before and at peak stress in a four-chamber view. The BNP (pg/mL) values of 67.3 +/- 47.5 (14-189) were elevated. There was no correlation between BNP and IVA, strain, or systolic and diastolic velocities at rest. Dobutamine stress led to a significant increase in IVA, s-velocity, and strain but no significant change in e-velocity. A correlation was found between increase in IVA under Dobutamine and BNP levels (r = 0.57, P < 0.02).

Conclusion: Elevated BNP levels correlate with response of systolic right ventricular function assessed by IVA to Dobutamine stress.

MeSH terms

  • Adolescent
  • Cardiotonic Agents / pharmacology
  • Dobutamine / pharmacology
  • Echocardiography, Stress
  • Echocardiography, Transesophageal
  • Female
  • Humans
  • Linear Models
  • Male
  • Myocardial Contraction / physiology*
  • Natriuretic Peptide, Brain / blood*
  • Transposition of Great Vessels / surgery
  • Ventricular Dysfunction, Right / blood*
  • Ventricular Dysfunction, Right / diagnostic imaging*
  • Ventricular Dysfunction, Right / physiopathology
  • Young Adult

Substances

  • Cardiotonic Agents
  • Natriuretic Peptide, Brain
  • Dobutamine