Cardiac MRI underlines the role of BNP and hematologic parameters as heart failure markers in patients with Ebstein's anomaly of the tricuspid valve

Abstract

Background Ebstein’s anomaly of the tricuspid valve involves a congenitally displaced and dysplastic tricuspid valve (TV). The displacement of the TV towards the apex results in an enlarged right atrium (RA) with an atrialzied portion of the right ventricle (aRV) and an enlarged functional right ventricle (fRV). Brain natriuretic peptide (BNP) is a heart failure marker. Its role in Ebstein’s anomaly has not been evaluated in conjunction with cardiac MRI (CMR) parameters. Hematologic parameters (hemoglobin (Hb), hematocrite (Hct)) are upregulated in states of pulmonary hypo perfusion as in congenital cyanotic heart disease. Intermittent Pulmonary hypo perfusion may be a an indicator of right heart failure in patients with Ebstein’s anomaly, but has not been studied so far. The aim of the present study was to correlate CMR functional parameters and severity of disease with BNP and hematologic parameters in patients with Ebstein’ sa nomaly. Methods 26 patients with non-corrected Ebstein’ sa nomaly were studied prospectively. Laboratory parameters (BNP, Hb, Hct), CMR data (RA, aRV, fRV, left atrial (LA) and left ventricular (LV) volumes and functional parameters like ejection fraction (EF), stroke volume (SV) and others) as well as exercise capacity (maximal oxygen uptake (VO2 max.), CO2 equivalent (VE/VCO2), maximum heart rate (max. HR) using a cycle ergometer) were all measured on the same day for an individual patient. Results