biostudies-literatureAvitabile CMNHLBI NIH HHS1431-1439https://www.ebi.ac.uk/biostudies/studies/S-EPMC7640722biostudies-literatureUnknown17(11)<b>Rationale:</b> Brain-type natriuretic peptide (BNP) correlates with pulmonary hypertension as demonstrated by echocardiogram in congenital diaphragmatic hernia (CDH); however, its association with right ventricular (RV) function and mortality is unknown.<b>Objectives:</b> To characterize the relationships between echocardiogram-derived RV strain, BNP, and mortality in diaphragmatic hernia.<b>Methods:</b> We performed a single-center retrospective cohort study of infants with CDH and at least one BNP-echocardiogram pair within a 24-hour period. RV global longitudinal strain (GLS) and free-wall strain (FWS) were measured on existing echocardiograms. Associations among strain, BNP, and mortality were tested using mixed-effect linear and logistic regression models. Survival analysis was stratified by BNP and strain abnormalities.<b>Results:</b> There were 220 infants with 460 BNP-echocardiogram pairs obtained preoperatively (<i>n</i> = 237), ≤1 week postoperatively (<i>n</i> = 35), and >1 week postoperatively ("recovery"; <i>n</i> = 188). Strain improved after repair (<i>P</i> < 0.0001 for all periods). Higher BNP level was associated with worse strain in recovery but not before or immediately after operation (estimate [95% confidence interval] for recovery: GLS, 1.03 [0.50-1.57]; <i>P</i> = 0.0003; FWS, 0.62 [0.01-1.22]; <i>P</i> = 0.047). BNP and strain abnormalities were associated with an extracorporeal-membrane oxygenation requirement. Higher BNP level in recovery was associated with greater mortality (odds ratio, 11.2 [1.2-571.3]; <i>P</i> = 0.02). Abnormal strain in recovery had high sensitivity for detection of mortality (100% for GLS; 100% for FWS) but had low specificity for detection of mortality (28% for GLS; 48% for FWS).<b>Conclusions:</b> Persistent RV dysfunction after CDH repair may be detected by a high BNP level and abnormal RV strain.Annals of the American Thoracic SocietyRight Ventricular Strain, Brain Natriuretic Peptide, and Mortality in Congenital Diaphragmatic Hernia.PMC7640722K01 HL125521Avitabile CMFrank DBAdams SMercer-Rosa LRintoul NEZhang XQuartermain MDSaavedra SHerkert LHedrick HLWang YGriffis HfalseRight Ventricular Strain, Brain Natriuretic Peptide, and Mortality in Congenital Diaphragmatic Hernia.<b>Rationale:</b> Brain-type natriuretic peptide (BNP) correlates with pulmonary hypertension as demonstrated by echocardiogram in congenital diaphragmatic hernia (CDH); however, its association with right ventricular (RV) function and mortality is unknown.<b>Objectives:</b> To characterize the relationships between echocardiogram-derived RV strain, BNP, and mortality in diaphragmatic hernia.<b>Methods:</b> We performed a single-center retrospective cohort study of infants with CDH and at least one BNP-echocardiogram pair within a 24-hour period. RV global longitudinal strain (GLS) and free-wall strain (FWS) were measured on existing echocardiograms. Associations among strain, BNP, and mortality were tested using mixed-effect linear and logistic regression models. Survival analysis was stratified by BNP and strain abnormalities.<b>Results:</b> There were 220 infants with 460 BNP-echocardiogram pairs obtained preoperatively (<i>n</i> = 237), ≤1 week postoperatively (<i>n</i> = 35), and >1 week postoperatively ("recovery"; <i>n</i> = 188). Strain improved after repair (<i>P</i> < 0.0001 for all periods). Higher BNP level was associated with worse strain in recovery but not before or immediately after operation (estimate [95% confidence interval] for recovery: GLS, 1.03 [0.50-1.57]; <i>P</i> = 0.0003; FWS, 0.62 [0.01-1.22]; <i>P</i> = 0.047). BNP and strain abnormalities were associated with an extracorporeal-membrane oxygenation requirement. Higher BNP level in recovery was associated with greater mortality (odds ratio, 11.2 [1.2-571.3]; <i>P</i> = 0.02). Abnormal strain in recovery had high sensitivity for detection of mortality (100% for GLS; 100% for FWS) but had low specificity for detection of mortality (28% for GLS; 48% for FWS).<b>Conclusions:</b> Persistent RV dysfunction after CDH repair may be detected by a high BNP level and abnormal RV strain.2020-01-01T00:00:00Z2020 Nov2026-05-07T16:24:52.08Z2026-04-30T03:06:01.626ZS-EPMC76407223273009910.1513/annalsats.201910-767oc10.1513/AnnalsATS.201910-767OC