Int J Cardiol Congenit Heart Dis. 2026 Jul 23;25:100699. doi: 10.1016/j.ijcchd.2026.100699. eCollection 2026 Sep.
ABSTRACT
BACKGROUND: The available data about the prognostic role of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in adults with congenital heart disease (CHD) are derived from small sample size with limited follow-up. The purpose of this study was to assess the role of NT-proBNP assay for prognostication in adults with CHD based on a large cohort.
METHOD: Retrospective cohort study of adults with CHD, biventricular physiology, and systemic morphologic left ventricle who had ≥2 NT-proBNP measurements (2003-2023). Temporal change in NT-proBNP was calculated as relative change from baseline levels (relative Δ_NT-proBNP).
RESULTS: Of 3674 patients (age 42 ± 16 years; 47% males), median baseline and follow-up NT-proBNP levels were 178 (72; 539) pg/ml and 236 (103; 854) pg/ml, respectively. The relative Δ_NT-proBNP was 22% (-9, 51), and 2496 (68%) had temporal increase in NT-proBNP levels (i.e., relative Δ_NT-proBNP >0). The correlates of higher baseline NT-proBNP measurement were older age, atrial fibrillation, hepatorenal dysfunction, biventricular systolic dysfunction, and elevated biventricular filling pressures. Overall, 431 (12%) patients died during median follow-up. Both baseline NT-proBNP level and temporal increase in NT-proBNP were associated with all-cause mortality in all patient subgroups. Serial NT-proBNP measurement had superior prognostic value compared to single (baseline) NT-proBNP measurements and had superior prognostic performance compared to conventional clinical indices (echocardiographic indices, invasive hemodynamic indices, exercise test indices).
CONCLUSIONS: NT-proBNP assay is inexpensive, readily available, and noninvasive, making it ideal for longitudinal monitoring. Further studies are required to determine whether NT-proBNP data can be used to guide therapeutic interventions in this population.
PMID:42571450 | PMC:PMC13452327 | DOI:10.1016/j.ijcchd.2026.100699