Background:Prognostic value ofNT-proBNP iswell established inpatientswith
congenital heart disease. Growing
evidence suggests that plasma NGAL is elevated in heart failure but data is
limited in congenital heart disease.
This study investigates the combined prognostic value of plasma NGALwith
plasmaNT-proBNP in adult patients
with congenital heart disease.
Methods:Plasma levels of NT-proBNP and NGALwere measured in 76 consecutive
adult patients (33 men, mean
age 31.7 ± 14 yrs)with congenital heart disease and normal values of
serumcreatinine. Patientswere divided in
three groups: A: simple cardiac lesions, B: complex cardiac lesions and C:
cyanotic lesions. Patients were also
monitored for long-term major cardiovascular events: death, hospitalization,
NYHA class worsening, new
onset of arrhythmias, surgical or percutaneous intervention.
Results:NGAL value was significantly different between groups: In group A
median NGAL value was 64.5 ±
36.7 ng/ml, in group B median NGAL value was 88.77± 36.17 ng/ml and in group C
median NGAL value
was 121 ± 40 ng/ml (group A vs. group B: p = 0.048, group B vs. group C: p =
0.037, group A vs. group C:
p = 0.003). Plasma NT-proBNP predicted all events (HR = 1.001, CI =
1.001–1.002, p = 0.0006) as well
as cardiovascular death alone (HR = 1.001, CI = 1.001–1.002, p = 0.0004);
plasma NGAL was the only pre-dictor of cardiovascular death (HR = 1.017, CI =
1.001–1.033, p = 0.037).
Conclusion:Plasma NGAL levels were lower in patients with simple congenital
disease compared to patients
with complex congenital heart disease and cyanotic congenital heart disease.
Plasma NGAL levels correlated
with NT-proBNP and could predict cardiovascular death in this small cohort of
Biomarkers, NGAL, Prognosis, Congenital heart disease